title: Low-dose thalidomide-induced agranulocytosis in a multiple myeloma patient treated at diagnosis.
abstract: 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.
authors.affiliation: Department of Medicine and Immunological Sciences, Division of Hematology and Transplants, University of Siena, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Mazzotta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gozzetti
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pirrotta
authors.forename: Monica
authors.initials: M
authors.lastname: Bocchia
authors.forename: Simona
authors.initials: S
authors.lastname: Sammassimo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bucalossi
authors.forename: Francesco
authors.initials: F
authors.lastname: Lauria
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide