Der Onkologe

, Volume 16, Issue 3, pp 298–308 | Cite as

Supportive Therapie bei multiplem Myelom

Leitthema
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Zusammenfassung

Das multiple Myelom kann durch Knochenzerstörung, Beeinträchtigung der Hämatopoese und der Nierenfunktion sowie durch Verursachung einer Infektneigung oder erhöhter Serumkalziumwerte zu einer vielfältigen Symptomatik führen. Diese Manifestationen auf Organebene beeinträchtigen naturgemäß auch das Wohlbefinden des Patienten. Eine grundlegende Einschränkung der Lebensqualität durch Komplikationen der Grunderkrankung oder Nebenwirkungen der Therapie kann sowohl auf der physischen, emotionalen als auch der psychosozialen Ebene manifest werden. Zu wesentlichen Supportivmaßnahmen bei Myelomerkrankung zählt die Prophylaxe und Behandlung von Knochendestruktion, Hyperkalzämie und Anämie, die Behandlung von Schmerzen und Infektionen, die Prophylaxe von Infektkomplikationen und thromboembolischen Ereignissen, letztere speziell auch bei Therapieregimen unter Einschluss immunomodulatorischer Substanzen. Im Folgenden werden wichtige Prinzipien der Supportivtherapie beim multiplen Myelom behandelt.

Schlüsselwörter

Bisphosphonate Erythropoesestimulierende Substanzen Infektprophylaxe Schmerztherapie Thromboseprophylaxe 

Supportive therapy of multiple myeloma

Abstract

Multiple myeloma is characterized by a multi-faceted clinical picture, where either bone destruction, suppression of normal hematopoiesis or renal dysfunction, recurrent infections or hypercalcemia are prominent. These organ dysfunctions translate naturally into a decreased well-being of the patient. A disruption of quality of life due to complications of the disease itself or side effects of therapy can affect the patient at the physical, emotional and psychosocial level. Supportive measures in the treatment of myeloma include prophylaxis and treatment of bone destruction, hypercalcemia, anemia, treatment of bone pain and infections and prophylaxis of infections and thromboembolic complications. This latter complication often affects patients under treatment with immunomodulatory drugs if prophylactic anticoagulation is not instituted. In the following the main principles of supportive therapy for myeloma patients will be delineated.

Keywords

Bisphosphonates Erythropoiesis-stimulating substances Prophylaxis of infections Analgesic therapy Thrombosis prophylaxis Prophylaxis of thrombotic complications 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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© Springer Medizin Verlag 2010

Authors and Affiliations

  1. 1.Medizinische AbteilungZentrum für Onkologie und Hämatologie, WilhelminenspitalWienÖsterreich

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