title: Guidelines for screening and management of late and long-term consequences of myeloma and its treatment.
abstract: A growing population of long-term survivors of myeloma is now accumulating the 'late effects' not only of myeloma itself, but also of several lines of treatment given throughout the course of the disease. It is thus important to recognise the cumulative burden of the disease and treatment-related toxicity in both the stable and active phases of myeloma, some of which is unlikely to be detected by routine monitoring. We summarise here the evidence for the key late effects in long-term survivors of myeloma, including physical and psychosocial consequences (in Parts 1 and 2 respectively), and recommend the use of late-effects screening protocols in detection and intervention. The early recognition of late effects and effective management strategies should lead to an improvement in the management of myeloma patients, although evidence in this area is currently limited and further research is warranted.
authors.affiliation: Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.|Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Snowden
authors.affiliation: Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.|Department of Oncology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Greenfield
authors.affiliation: University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Bird
authors.affiliation: Palliative Medicine, Queen's Centre for Oncology and Haematology, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Boland
authors.affiliation: King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Stella
authors.initials: S
authors.lastname: Bowcock
authors.affiliation: University College London, London, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Fisher
authors.affiliation: Myeloma UK, Edinburgh, UK.
authors.forename: Eric
authors.initials: E
authors.lastname: Low
authors.affiliation: Myeloma UK, Edinburgh, UK.
authors.forename: Monica
authors.initials: M
authors.lastname: Morris
authors.affiliation: University College London, London, UK.
authors.forename: Kwee
authors.initials: K
authors.lastname: Yong
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Pratt
mesh_terms: D019468:Disease Management; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D017741:Survivors / Q000523:psychology; D013997:Time Factors
keywords: chemotherapy; haematopoietic stem cell transplantation; late effects; myeloma; quality of life