Management of treatment-related adverse events in patients with multiple myeloma

Cancer Treat Rev. 2010 May:36 Suppl 2:S24-32. doi: 10.1016/S0305-7372(10)70009-8.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Boronic Acids / adverse effects*
  • Bortezomib
  • Disorders of Excessive Somnolence / chemically induced
  • Disorders of Excessive Somnolence / therapy
  • Gastrointestinal Diseases / chemically induced
  • Gastrointestinal Diseases / therapy
  • Hematologic Diseases / chemically induced
  • Hematologic Diseases / therapy
  • Humans
  • Lenalidomide
  • Multiple Myeloma / drug therapy*
  • Peripheral Nervous System Diseases / chemically induced
  • Peripheral Nervous System Diseases / therapy
  • Pyrazines / adverse effects*
  • Thalidomide / adverse effects*
  • Thalidomide / analogs & derivatives*
  • Venous Thromboembolism / chemically induced
  • Venous Thromboembolism / therapy

Substances

  • Antineoplastic Agents
  • Boronic Acids
  • Pyrazines
  • Thalidomide
  • Bortezomib
  • Lenalidomide