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.
Declaration of Interests
These BSH Guidelines were coordinated by JAS and GP, wholed on their development with the British Society for Haematology and UK Myeloma Forum. All authors were involved in writing and revising the manuscript and approved of the submitted and final versions. The authors acknowledge the generous support of Myeloma UK, who paid the expenses of an independent medical writer, Dr Vivienne Kendall, who assisted with literature searches, writing and revision of the manuscript by all authors. JAS acknowledges the support of Sheffield Hospitals Charity. All authors have made a declaration of interests as per BSH Guidelines Committee procedures, which may be viewed on request.