Comorbidities in patients with multiple myeloma
DOI:
https://doi.org/10.14739/2409-2932.2019.2.171245Keywords:
comorbidity, multiple myeloma, cardiovascular diseases, renal insufficiency, infections, proteasome inhibitor, immunomodulationAbstract
Most clinicians consider performance status and comorbidities rather than chronological age in determining prognosis and treatment. Significant advancements in the treatment of myeloma have occurred including routine use of proteasome inhibitors and immunomodulatory drugs; however, the impact of comorbidity on clinical outcomes has not been fully investigated.
Here, we performed a review of the literature utilizing PubMed search engines to identify all publications comparing influence of comorbidities on survival of patients with multiple myeloma.
Comorbidities of patients with multiple myeloma have been demonstrated to affect progression-free survival and overall survival. Infections pose the greatest risk of early death in these patients. Cardiovascular and renal impairment is a dreaded complication in multiple myeloma and has been associated with decreased progression-free survival and overall survival. Cardiovascular complications associated with proteasome inhibitors and immunomodulatory drugs are an important component in supportive care of patients with myeloma.
Conclusions. Comorbidity plays a critical role in the outcome of myeloma patients in terms of early mortality. The management of multiple myeloma patients with comorbidities is a challenge that should be addressed improving the measurement of comorbidity and the coordination of care.
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