Guidelines for supportive care in multiple myeloma 2011

Br J Haematol. 2011 Jul;154(1):76-103. doi: 10.1111/j.1365-2141.2011.08574.x. Epub 2011 Apr 22.


Supportive care plays an increasingly important role in the modern management of multiple myeloma. While modern treatments have significantly prolonged overall and progression free survival through improved disease control, the vast majority of patients remain incurable, and live with the burden of the disease itself and the cumulative side effects of treatments. Maintenance of quality of life presents challenges at all stages of the disease from diagnosis through the multiple phases of active treatment to the end of life. Written on behalf of the British Committee for Standards in Haematology (BCSH) and the UK Myeloma Forum (UKMF), these evidence based guidelines summarize the current national consensus for supportive and symptomatic care in multiple myeloma in the following areas; pain management, peripheral neuropathy, skeletal complications, infection, anaemia, haemostasis and thrombosis, sedation, fatigue, nausea, vomiting, anorexia, constipation, diarrhoea, mucositis, bisphosphonate-induced osteonecrosis of the jaw, complementary therapies, holistic needs assessment and end of life care. Although most aspects of supportive care can be supervised by haematology teams primarily responsible for patients with multiple myeloma, multidisciplinary collaboration involving specialists in palliative medicine, pain management, radiotherapy and surgical specialities is essential, and guidance is provided for appropriate interdisciplinary referral. These guidelines should be read in conjunction with the BCSH/UKMF Guidelines for the Diagnosis and Management of Multiple Myeloma 2011.

Publication types

  • Guideline
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anemia / etiology
  • Anemia / therapy
  • Bone Density Conservation Agents / adverse effects
  • Complementary Therapies / methods
  • Diphosphonates / adverse effects
  • Evidence-Based Medicine / methods
  • Hemostatic Techniques
  • Humans
  • Jaw / drug effects
  • Multiple Myeloma / complications*
  • Multiple Myeloma / therapy
  • Opportunistic Infections / complications
  • Opportunistic Infections / prevention & control
  • Osteonecrosis / chemically induced
  • Osteonecrosis / therapy
  • Pain / diagnosis
  • Pain / etiology
  • Pain Management
  • Pain Measurement / methods
  • Peripheral Nervous System Diseases / etiology
  • Peripheral Nervous System Diseases / therapy
  • Terminal Care / methods
  • Thrombosis / etiology
  • Thrombosis / therapy


  • Bone Density Conservation Agents
  • Diphosphonates