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What the Intensivists Need to Know About Critically Ill Myeloma Patients

  • Ranjit Nair
  • Krina PatelEmail author
Reference work entry

Abstract

Multiple myeloma (MM) is a hematological malignancy characterized by an increase in aberrant plasma cells in the bone marrow leading to rising monoclonal protein in serum and urine. With the introduction of novel therapies with manageable side effects, this incurable disease has evolved into a chronic disease with an acceptable quality of life for the majority of patients. Accordingly, management of acute complications is fundamental in reducing the morbidity and mortality in MM. MM emergencies include symptoms and signs related directly to the disease and/or to the treatment; many organs may be involved including, but not limited to, renal, cardiovascular, neurologic, hematologic, and infectious complications. This review will focus on the numerous approaches that are aimed at managing these complications.

Keywords

Multiple myeloma Oncologic emergencies 

Abbreviations

AF

Atrial fibrillation

ARDS

Acute respiratory distress syndrome

BAL

Bronchoalveolar lavage

DAH

Diffuse alveolar hemorrhage

DVT

Deep vein thrombosis

eGFR

Estimated glomerular filtration rate

FLC

Free light chain

IgA

Immunoglobulin A

IgG

Immunoglobulin G

IgM

Immunoglobulin M

LC

Light chain

LMM

Leptomeningeal myelomatosis

MM

Multiple myeloma

MRI

Magnetic resonance imaging

PCR

Polymerase chain reaction

PE

Pulmonary embolism

RIFLE

Risk of renal injury/injury to the kidney/failure of kidney function/loss of kidney function/end-stage disease

RT

Radiation therapy

RV

Right ventricle

sCr

Serum creatinine

TLS

Tumor lysis syndrome

TPE

Therapeutic plasma exchange

Notes

Conflicts of Interest

KP = research funds from Poseida, Intrexon/Ziopharm, Takeda. Advisory board/consultancy in Takeda, DAVA oncology, Celgene, Janssen, Amgen, BMS, and Oncopeptides.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Lymphoma and Myeloma, Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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