Maintenance therapy and supportive care for patients with multiple myeloma

Although multiple myeloma remains incurable, several drug therapies are valuable in the management of patients suffering from this condition. Interferon-alpha2b and prednisone are two agents that have been shown to modestly prolong disease-free survival when each is used as monotherapy and when used in combination. Bone resorption and anemia are among several complications that adversely affect health and quality of life in patients with multiple myeloma. Bone resorption leads to skeletal complications, such as pathologic fractures, pain, spinal cord compression, and hypercalcemia. Bisphosphonates are specific inhibitors of osteoclastic activity that can be used to treat bone resorption. Intravenous pamidronate is effective in preventing skeletal complications and also may exert a direct inhibitory effect on myeloma cells. Exogenous epoetin alfa is helpful in treating more than half of patients with anemia during the plateau state of multiple myeloma. Overall, the management of patients with multiple myeloma is complex and should focus on the treatment of the disease process and the associated complications.