Why There’s Improved Outlook for Myeloma Patients

Print icon
By Dr. Peter Byeff

The prognosis for multiple myeloma is gradually improving as a result of new and improved therapies.

Multiple myeloma, which causes cancer cells to accumulate in bone marrow, can affect people of all ages, although the average age of onset is the sixth decade of life. New treatments including high-dose chemotherapy with stem cell support for appropriate patients, drugs in the classes of proteasome inhibitors, IMiDs (Immunomodulatory imide drugs) and other monoclonal antibodies such as daratumumab as well as bisphosphonates, which help to decrease skeletal-related events, have had a very significant impact on quality of life and survival.  Nonetheless, survivors face a number of challenges.

Long-term toxicity from treatments include neuropathy due to several of the new classes of drugs. Although it is an uncommon side effect, bone injury of the jaw secondary to treatment with bisphosphonates, can create very significant toxicity, which requires additional therapy.  Survivors also often have altered immunity, which makes them susceptible to a variety of infections.  The altered immunity may be due to myeloma itself, which often is accompanied by severe background suppression of the normal immune system and is sometimes treated by immune infusions that are given monthly.  Additionally, decreased immune response may be secondary to high dose chemotherapy with stem cell support or to drugs such as steroids which are used to treat myeloma.

Bone health is another issue for myeloma survivors.  They often have osteoporosis and involved bone lesions that may fracture. They often continue to receive medications to help bone health for a prolonged period to decrease the risk of a skeletal-related event.  Continued monitoring of the skeletal system is necessary.

Survivors of myeloma not infrequently will have diminished kidney function that may have been caused by the myeloma protein or elevated calcium levels in the blood. They may require continued surveillance for this. Decreased renal function may cause chronic anemia and may require treatment with agents such as epoetin to maintain an adequate red blood count.

Long-term survivors of myeloma are at significant risk of developing myelodysplasia, a chronic condition of white blood cells that may transform into acute leukemia, or acute leukemia itself due to the combined effects of therapy.  Survivors need continual monitoring of their blood counts to assess for any blood cell abnormalities.

The need for ongoing monitoring and treatment with these new cadre of medications may provide significant economic challenges to survivors due to the costs of these therapies. The Hartford HealthCare Cancer Institute offers financial and psychosocial counseling to help support patients and families during their cancer journey.

Dr. Peter Byeff is a Hartford HealthCare oncologist.

For more information on the Hartford HealthCare Cancer Institute and multiple myeloma, click here.

What's New

Pancreatic Cancer

Free Pancreatic Care Webinar June 11

The fourth leading cause of cancer death in both men and women, pancreatic cancer, is an aggressive form of the disease that often exhibits few symptoms until it is advanced. Approximately 57,000 Americans will be diagnosed with it this year, according to the American Cancer Society. About 47,000 will die...

Jeffrey A. Flaks

A Message From Hartford HealthCare CEO Jeffrey Flaks

With the concerns about coronavirus and COVID-19, I want to assure you that Hartford HealthCare is doing everything possible to protect the safety and well-being of the people and the communities we serve, and our team of healthcare providers. Our goal is to be ready and prepared for whatever is...

Quite Smoking

Trying to Quit Smoking? Here’s Some Help

Editor’s note: Initial studies have shown that if you smoke and get COVID-19, you’re 14 times more likely than nonsmokers to require intensive treatment. If you’ve considered stopping smoking, now is a good time. By Ellen Anderson Dornelas, PhD Director, Cancer Care Delivery and Disparities Research Hartford Healthcare Cancer Institute...

Pancreatic Cancer Recovery

How to Manage Pancreatic Cancer Treatment’s Side Effects

A pancreatic cancer survivor is any person who is actively facing pancreatic cancer or has faced it at some point. It could be someone who has completed treatment or a patient actively receiving chemotherapy for a limited or long-term management of their disease. Patients treated with chemotherapy experience a variety...

Breast Cancer Awareness

The New Normal for Breast Cancer Survivors

The word “patient” stems from the Latin word patiens, meaning sufferer. Until recently, a diagnosis of cancer conveyed a sense of victimhood and loss of control, hence labels such as “cancer patient” or “cancer victim.” Despite good intentions, these terms left those with a cancer diagnosis feeling isolated and somehow...