Quality of life aspect in therapeutic approach to patients with multiple myeloma

Multipli mijelom je maligna bolest koštane srži karakterizirana neoplastičnom proliferacijom plazma stanica, praćena abnormalnim porastom monoklonskih imunoglobulina koji se mogu detektirati u serumu ili urinu. Unatoč značajnim poboljšanjima u liječenju multiplog mijeloma, to je još uvijek kronična, neizlječiva bolest koja je povezana sa smanjenom HRQoL zbog spontanih prijeloma, osteolitičkih lezija, rekurentnih infekcija, zatajenja bubrega, anemije, psiholoških poremećaja i drugih povezanih problema. Redovitom procjenom pacijentove HRQoL tijekom cijele bolesti, kliničari mogu dobiti uvid u pacijentovo zdravstveno stanje, razinu boli, njegovo fizičko funkcioniranje te u skladu s tim mogu razviti plan liječenja. Najčešće korišteni upitnici u procjeni HRQoL u bolesnika s multiplim mijelomom kao što su EORTC QLQ-C30 i EORTC QLQ-MY20, prema rezultatima pojedinačnih istraživanja nisu dovoljno sveobuhvatni te je potrebno raditi na njihovom poboljšanju. Uvođenje novih lijekova tijekom posljednjih nekoliko godina dovelo je do značajnog poboljšanja u preživljenju, ali nuspojave nekih tretmana uzrokuju značajno smanjenje HRQoL. Stoga se u rutinskoj kliničkoj skrbi mora obratiti pozornost na praćenje HRQoL nakon primjene određenih terapijskih protokola. Uz liječenje same bolesti, profilaksa i potporno liječenje osteolitičkih lezija, boli, anemije, zatajenja bubrega, umora, infekcija, hiperkalcemije i periferne neuropatije su ključni dijelovi terapijskog liječenja pacijenata s multiplim mijelomom.Multiple myeloma is a malignant bone marrow disease characterized by neoplastic proliferation of plasma cells, accompanied by an abnormal increase in monoclonal immunoglobulins that can be detected in serum or urine. Despite significant improvements in the treatment of multiple myeloma, it is still a chronic, incurable disease that is associated with reduced HRQoL due to spontaneous fractures, osteolytic lesions, recurrent infections, renal failure, anaemia and psychological disorders and other related problems. By assessing a patient’s HRQoL regularly throughout their disease, clinicians can gain insight into the patient's health condition, pain level, physical functioning, and they can develop a treatment plan accordingly. The most often used questionnaires in assessment of HRQoL in patients with multiple myeloma such as EORTC QLQ-C30 and EORTC QLQ-MY20, according to the results of individual researches, are not good enough, and it is necessary to work on their improvement. The introduction of novel therapies over the past few years has led to significant improvement in survival, but side effects of some treatment cause a significant reduction in HRQoL. Therefore, in routine clinical care, attention must be paid to monitoring HRQoL after the application of certain therapeutic protocols. In addition to treatment of the disease itself, prophylaxis and supportive treatment of bone destruction, pain, anaemia, renal failure, fatigue, infections, hypercalcaemia and peripheral neuropathy are essential parts of the therapeutic management of multiple myeloma patients