Treatment and Disease-related Complications in Multiple Myeloma

Multiple myeloma is a clonal plasma cell neoplasm that is mainly characterized by anemia, renal insufficiency, hypercalcemia, and bone destruction. Since 1990, there is an increase in the incidence of myeloma globally by 126%. However, due to the presence of the new therapeutic agents such as proteasome inhibitors, immunomodulatory drugs, Chimeric antigen receptor T-cell therapy, bispecific antibodies, bisphosphonates, corticosteroids, melfulfen, iberdomide, cyclophosphamide, plerixafor, melphalan chemotherapy, nuclear transport inhibitor, and monoclonal antibodies, as well as upfront autologous and allogeneic hematopoietic cell transplantation in eligible patients, a decline in the age-standardized mortality rate has been seen. This leads to higher survival rates of patients with multiple myeloma in the last 15 years, and hence, patients with multiple myeloma for 10–15 years are no longer rare. However, it has been observed that even though the treatment goal was to prevent end-organ damage, improve or maintain quality of life (QoL), and achieve long-term disease-free survival; thus, new treatments have converted myeloma into a chronic disease, such as peripheral neuropathy (PN), venous thromboembolism, and cardiac toxicity. Notably, most patients remain on continuous treatment for extended time periods, which leads to various complications. Hence, management of immediate and late complications from disease and treatment is a critical component of survivorship care in myeloma.