Anemia and infections in multiple myeloma: supportive therapy

Patients with multiple myeloma (MM) have a high rate of infectious complications and symptomatic anemia. Emerging antineoplastic therapies are resulting in a better response, but still quality of life and potentially survival can be significantly affected by these complications. Multiple cytokines and an impaired immunologic system are involved in the development of these complications. Emerging therapies and guidelines will be reviewed taking in consideration the benefits versus risks of those strategies. The beneficial effect of recombinant human erythropoietin (EPO) and darbepoietin alpha in MM patients have been confirmed in several trials. Evidenced-based guidelines for the use of EPO in patients with cancer should be closely followed to ensure correct use of erythropoiesis stimulating agents. Infection, despite being the most common cause of morbidity and mortality, can be controlled by prompt recognition and proper prophylaxis.Supportive care is an important adjunct to cancer therapy. Adequate use of pharmacologic strategies to control anemia and prevent or treat infectious complications will result in benefit to MM patients.