Low-dose thalidomide-induced agranulocytosis in a multiple myeloma patient treated at diagnosis.
Thalidomide represents a recent and innovative therapeutic approach in multiple myeloma. Main toxicity usually consists in somnolence, constipation, peripheral neuropathy and deep vein thrombosis, but, unlike alkylating agents, thalidomide is reported to rarely induce severe hematologic toxicity. The majority of patients developing neutropenia are heavily pretreated with three or more lines of chemotherapy. Here, we report, for the first time, clinical and laboratory data of a 66-year-old female patient with multiple myeloma at diagnosis who, after 4 weeks of thalidomide treatment, developed a grade 4 WHO neutropenia with septicemia. A brief review of the literature and suggestions for possible predictive factors of this toxicity are made.
Mazzotta
Serena
S
Department of Medicine and Immunological Sciences, Division of Hematology and Transplants, University of Siena, Italy.
Gozzetti
Alessandro
A
Pirrotta
Maria Teresa
MT
Bocchia
Monica
M
Sammassimo
Simona
S
Bucalossi
Alessandro
A
Lauria
Francesco
F
D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced*; D000970:Antineoplastic Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy*; D013792:Thalidomide / Q000009:adverse effects*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D013792:Thalidomide