Rehabilitation Management for Patients with Multiple Myeloma

Multiple myeloma (MM) is the second most common blood cancer. Bone involvement is very common in these patients: it is estimated that between 80% and 90% will develop bone lesions during the course of the disease. This represents a potential risk of fragility and pain, significantly impacting the patient's functional status and therefore worsening their quality of life. \[1\] The presence of bone lesions also represents a risk for the development of Skeletal-Related Events (SREs), which can include: pathological fractures, vertebral compression that causes spinal cord compression, and the need for surgery or radiotherapy to treat the bone lesions. It is important to monitor and manage SREs as they are associated with increased mortality. With the improvement of treatments and increased survival rates, more and more patients require rehabilitation management, which includes therapeutic education, the prescription of orthoses/aids, and specific rehabilitation programs to address fatigue or cope with major events such as SREs. Also frequently needed are guidelines regarding safe physical activity and support for returning to work or resuming satisfying social participation. In many MM patients, bone involvement represents a challenge for the rehabilitation specialist, who must be able to perform an accurate assessment of the risks and benefits of treatment to avoid exposing the patient to unnecessary risks or complications. Managing the patient within a multidisciplinary team of specialists can improve the accuracy of the overall assessment and therapeutic recommendations. The aim of our study is to retrospectively analyze patients with a new diagnosis of MM who were managed by the Hematology Department in 2019, 2020, and 2021, in order to describe and evaluate any SREs, as well as some clinical and rehabilitation data.

Multiple myeloma (MM) is the second most common blood cancer. Bone involvement is very common in these patients: it is estimated that between 80% and 90% will develop bone lesions during the course of the disease. This represents a potential risk of fragility and pain, significantly impacting the patient's functional status and thus worsening their quality of life. Furthermore, the presence of bone lesions represents a risk for the development of Skeletal-Related Events (SREs), which can include pathological fractures, vertebral compressions causing spinal cord compression, and the need for surgery or radiotherapy to treat bone lesions. It is important to monitor and manage SREs as they are associated with an increased risk of mortality. With improvements in treatment and increased survival, more and more patients require rehabilitative care, which includes therapeutic education, the prescription of orthoses/aids, the implementation of specific rehabilitation programs to counter fatigue, or to address major events such as SREs. Equally important are guidelines regarding safe physical activity and support for returning to work or resuming satisfying social participation. In many MM patients, bone involvement represents a challenge for the rehabilitation professional, who must be able to make an accurate assessment of the risks and benefits of treatment to avoid exposing the patient to inappropriate risks or complications. Caring for the patient within a multidisciplinary team of specialists can improve the accuracy of the overall assessment and therapeutic recommendations. The aim of our study is to retrospectively analyze patients with a new diagnosis of MM who were managed by the Hematology Department in the years 2019, 2020, and 2021, in order to describe and assess any SREs, as well as some clinical and rehabilitative data.