Supportive Care in Multiple Myeloma: Evidence-Based Recommendations From the Intergroupe Francophone du Myélome (IFM)
Year: 2026
Type: review
Abstract: Multiple myeloma (MM) is a largely incurable plasma cell malignancy in which disease- and treatment-related complications substantially impair quality of life and survival, making supportive care a central determinant of outcome. This review presents unified, evidence-based recommendations from the Intergroupe Francophone du Myélome across 7 domains of supportive care and their implications for contemporary practice, including the era of T-cell-redirecting immunotherapy. With the advent of highly effective induction regimens, autologous stem cell transplantation, immunomodulatory drugs, proteasome inhibitors, anti-CD38 monoclonal antibodies, bispecific antibodies (BsAbs), and chimeric antigen receptor T-cell (CAR-T) therapies, the prevention and management of treatment-emergent toxicities and disease-related sequelae have become increasingly complex. Synthesizing a structured review of the literature, international guidelines, and formal expert consensus, we provide practical recommendations for (1) venous thromboembolism prophylaxis, (2) prevention of skeletal-related events with bone-modifying agents, (3) prevention of infectious complications, (4) vaccination, (5) management of MM-related anemia with erythropoiesis-stimulating agents, (6) adapted physical activity, and (7) practical guidance for the management of treatment-emergent peripheral neuropathy, with particular attention to the specific challenges introduced by BsAbs and CAR-T therapy. By consolidating these 7 domains into a single framework applicable across all lines of therapy, from first-line treatment to relapsed/refractory disease, this review offers a pragmatic reference intended to standardize and improve supportive care and, ultimately, patient outcomes and health-related quality of life in MM. Positions that deliberately differ from other international guidelines-notably those of the International Myeloma Working Group-are explicitly identified and justified.
Authors: Laurent Frenzel, Pascal Godmer, Alexis Talbot, Cécile Sonntag, Stéphanie Harel, Thomas Chalopin, Salomon Manier, Cyrille Hulin, Thierry Facon, Lionel Karlin, Jill Corre, Philippe Moreau, Cyrille Touzeau, Xavier Leleu, Olivier Decaux, Bertrand Arnulf, Chanaz Louni, Mohamad Mohty, Aurore Perrot, Emilie Chalayer, Murielle Roussel
Institutions: Hôpital Necker-Enfants Malades, Memorial Sloan Kettering Cancer Center, Assistance Publique – Hôpitaux de Paris, Centre hospitalier Bretagne Atlantique, Inserm, Université Paris Cité, Hôpital Saint-Louis, Institut de recherche Saint-Louis, Hôpitaux Universitaires de Strasbourg, Centre Hospitalier Universitaire de Tours, Centre Hospitalier Universitaire de Lille, Centre Hospitalier Universitaire de Bordeaux, Hospices Civils de Lyon, Institut universitaire du cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Nantes, Centre Hospitalier Universitaire de Poitiers, Centre Hospitalier Universitaire de Rennes, Intergroupe Francophone du Myélome, Sorbonne Université, Hôpital Saint-Antoine, Université de Toulouse, SAnté INgenierie BIOlogie Saint-Etienne, Université Jean Monnet, Centre National de la Recherche Scientifique, Centre Hospitalier Universitaire de Limoges, Contrôle de la Réponse Immune B et Lymphoproliférations, Université de Limoges
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,890
OpenAlex ID: W7212746268