Myelosuppression, Bone Disease, and Acute Renal Failure: Evidence-Based Recommendations for Oncologic Emergencies

Kevin Brigle, PhD, NP; Amy Pierre, ANP-BC; Elizabeth Finley-Oliver, BSN, RN, OCN®; Beth Faiman, PhD, MSN, APRN-BC, AOCN®; Joseph D. Tariman, PhD, RN, ANP-BC, FAAN; Teresa Miceli, BSN, RN, OCN®


Background: Oncologic emergencies associated with multiple myeloma include myelosuppression (anemia, neutropenia, and thrombocytopenia), bone-related emergencies, and acute renal failure. 

Objectives: This article reviews the pathophysiology of these multiple myeloma-associated oncology emergencies and provides a framework for assessment and effective intervention.

Methods: A comprehensive review of the levels of evidence, focusing on assessment, diagnosis, comorbidities, treatment, ongoing monitoring, and patient education, are presented to support the plan of care for at-risk patients.

Findings: Attention to signs and symptoms is the foundation for preventing these emergencies or managing additional escalation of symptoms.

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