What follow-up monitoring is necessary for patients undergoing treatment for multiple myeloma to assess response and manage side effects?

Patients undergoing treatment for multiple myeloma require regular follow-up monitoring to assess their response to therapy and manage potential side effects. Monitoring should include:

• Regular assessment of symptoms related to myeloma and treatment side effects, including fatigue, neuropathy, and infection risk.
• Laboratory tests such as full blood count, renal function, bone profile, serum immunoglobulins, serum protein electrophoresis, and serum-free light-chain assay where appropriate to evaluate disease activity and organ function.
• Monitoring frequency is typically every 3 months after treatment completion and recovery, with adjustments based on risk factors like high-risk FISH, renal impairment, and disease presentation.
• Routine skeletal surveys are not recommended for disease monitoring; instead, symptom-directed imaging should be considered if new bone symptoms develop.
• For serological relapse or disease progression, advanced imaging such as whole-body MRI, spinal MRI, or FDG PET-CT should be considered.
• Management of side effects includes vigilance for neuropathy, with dose adjustments or treatment modifications if neuropathic symptoms develop, and infection prevention strategies including vaccinations and antiviral prophylaxis as indicated.

This comprehensive approach ensures timely detection of disease progression and side effects, enabling appropriate therapeutic adjustments and supportive care.

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