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Pain Syndromes of Hematologic Malignancies

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Palliative Care in Hematologic Malignancies and Serious Blood Disorders

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Abstract

Despite significant advances in the therapeutic options and prognoses of hematologic malignancies (HM), pain remains a significant complication that adversely impacts functionality and quality of life (QOL). Plasma cell dyscrasias, such as multiple myeloma, result in significant pain syndromes owing to the pathophysiology of the disease, in particular the development of osteolytic lesions and subsequent bone fractures. In certain myeloproliferative neoplasms, the development of secondary erythromelalgia may result in pain and erythema in response to heat and exercise. Disease-specific treatments, coupled with agents directed at the underlying mechanism of disease, may lead to improved symptom and pain control. Oftentimes, pain may result directly from cytotoxic chemotherapy or supportive treatments used to minimize disease-related morbidity and mortality. Lastly, pain and other noxious symptoms may result from hematopoietic cell transplantation (HCT), due to both the conditioning regimen, supportive medications, and the alloreactivity observed in graft-versus-host disease (GVHD). Opioid analgesics form the cornerstone of a wide array of pain and symptom control strategies in patients suffering from HM. Special care and attention must be devoted to the responsible use of these medications, as well as the risk for dependence and addiction.

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Authors and Affiliations

  1. Division, Hematology-Oncology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Judith A. Paice

  2. Division of Hematology/Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Jonathan Moreira

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  1. Judith A. Paice
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Correspondence to Jonathan Moreira .

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  1. Harvard Medical School, Boston, MA, USA

    Christina K. Ullrich

  2. Oregon Health and Science University, Portland, OR, USA

    Eric J. Roeland

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Paice, J.A., Moreira, J. (2023). Pain Syndromes of Hematologic Malignancies. In: Ullrich, C.K., Roeland, E.J. (eds) Palliative Care in Hematologic Malignancies and Serious Blood Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-38058-7_13

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