Management of treatment-related adverse events in patients with multiple myeloma.
The introduction of novel antimyeloma therapies, including thalidomide, lenalidomide and bortezomib, has expanded treatment options for patients with multiple myeloma. These compounds alter the natural history of multiple myeloma and help improve outcomes, but have different and specific toxicity profiles. The major adverse events associated with these treatments are somnolence (thalidomide), venous thromboembolism (thalidomide and lenalidomide), myelosuppression (lenalidomide and bortezomib), gastrointestinal disturbance, and peripheral neuropathy (thalidomide and bortezomib). These adverse events are predictable, consistent, and manageable with patient monitoring, supportive care, and dose reduction and interruption where appropriate. Herein we evaluate the incidence of treatment-related adverse events associated with each of these compounds. We further review the management of these adverse events with a view to delivering optimal therapeutic outcomes in patients with newly diagnosed and relapsed and/or refractory multiple myeloma.
Mateos
María-Victoria
MV
Haematology Department, University Hospital of Salamanca, Salamanca, Spain. mvmateos@usal.es
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced / Q000628:therapy; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000628:therapy; D006402:Hematologic Diseases / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy; D011719:Pyrazines / Q000009:adverse effects*; D013792:Thalidomide / Q000009:adverse effects* / Q000031:analogs & derivatives*; D054556:Venous Thromboembolism / Q000139:chemically induced / Q000628:therapy
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide