Monday, August 9, 2021

Multiple myeloma

First10EM - By Justin Morgenstern - August 9, 2021
In the Rapid Review series, I briefly review the key points of a clinical review paper or two. The topic: Multiple Myeloma
The papers: 
  • Nau KC, Lewis WD. Multiple myeloma: diagnosis and treatment. Am Fam Physician. 2008 Oct 1;78(7):853-9. PMID: 18841734
  • Eslick R, Talaulikar D. Multiple myeloma: from diagnosis to treatment. Aust Fam Physician. 2013 Oct;42(10):684-8. PMID: 24130968
There is not much to do in the emergency department, aside from treating the patient’s presenting complaint and managing hypercalcemia or acute renal failure (if present). Renal impairment is very common, and so NSAIDs should be avoided (which is important as pain is the most common presenting complaint). Patients will get an oncology referral. Many patients (those without symptoms) are not treated at all, as earlier treatment does not improve mortality but does increase the risk of acute leukemia.