title: Outcomes and management of lenalidomide-associated rash in patients with multiple myeloma.
abstract: The immunomodulatory drugs thalidomide, lenalidomide, and pomalidomide (IMiDs) are an important component of myeloma treatment; one of six available drug classes for this incurable disease. Rash is a frequent side effect of IMiDs, particularly lenalidomide, often leading to treatment discontinuation. We retrospectively reviewed 52 patients (7.2% of patients seen during that time) with IMiD associated at a median of 3 weeks after exposure. Nearly all rashes were morbilliform, and 45% of evaluable rashes were grade 3-4 by NCI-CTCAE criteria. IMiDs were initially held in 33 patients (62%), and 25% received a short course of higher dose steroids. Seventy-nine percent of patients were reexposed to the same IMiD, often with dose reduction, and 57% were switched from weekly dexamethasone to thrice-weekly prednisone. Ninety-three percent of patients reexposed to the same IMiD with these interventions were able to tolerate and continue treatment, and only 14% had rash with reexposure, predominantly grade 1-2.
authors.affiliation: a Hematology and Oncology, Multiple Myeloma Program , Icahn School of Medicine at Mount Sinai , New York , NY , USA ;
authors.forename: Kevin
authors.initials: K
authors.lastname: Barley
authors.affiliation: a Hematology and Oncology, Multiple Myeloma Program , Icahn School of Medicine at Mount Sinai , New York , NY , USA ;
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.affiliation: b Department of Allergy and Immunology, Multiple Myeloma Program , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Shradha
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: a Hematology and Oncology, Multiple Myeloma Program , Icahn School of Medicine at Mount Sinai , New York , NY , USA ;
authors.forename: Sundar
authors.initials: S
authors.lastname: Jagannath
authors.affiliation: a Hematology and Oncology, Multiple Myeloma Program , Icahn School of Medicine at Mount Sinai , New York , NY , USA ;
authors.forename: Ajai
authors.initials: A
authors.lastname: Chari
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005076:Exanthema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Lenalidomide; myeloma; pomalidomide; rash; thalidomide