Lenalidomide treatment for patients with multiple myeloma: Diagnosis and management of most frequent adverse events

Persona, Ernesto Pérez; Mesa, Mercedes Gironella; Sánchez, Pedro José García; Rodríguez, Azucena

doi:10.1007/s12325-010-0102-x

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…However, approximately 10% of subjects fail to achieve this goal (22) and require the employment of remobilization strategies. This percentage is even higher in multiple myeloma subjects previously treated with lenalidomide in whom mobilization failure approaches 30% (8). Moreover, the collection success rate in patients mobilized with G-CSF only in an attempt to reduce chemo-mobilization toxicity is even lower, emphasizing the need for new mobilization protocols (17).…”

Section: Discussionmentioning

confidence: 99%

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The High-Affinity CXCR4 Antagonist BKT140 Is Safe and Induces a Robust Mobilization of Human CD34+ Cells in Patients with Multiple Myeloma

Peled

Abraham

Avivi

et al. 2014

Clinical Cancer Research

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Purpose: CXCR4 plays an important role in the retention of stem cells within the bone marrow. BKT140 (4F-benzoyl-TN14003) is a 14-residue bio stable synthetic peptide, which binds CXCR4 with a greater affinity compared with plerixafor (4 vs. 84 nmol/L). Studies in mice demonstrated the efficient and superior mobilization and transplantation of stem cells collected with GCSF-BKT140, compared with those obtained when using stem cells obtained with each one of these mobilizing agent alone. These results have served as a platform for the present clinical phase I study.Experimental Design: Eighteen patients with multiple myeloma who were preparing for their first autologous stem cell transplantation were included. Patients received a standard multiple myeloma mobilization regimen, consisting of 3 to 4 g/m 2 cyclophosphamide (day 0), followed by granulocyte colony-stimulating factor (G-CSF) at 5 mg/kg/d starting on day 5 and administered between 8 and 10 pm until the end of stem cell collection. A single injection of BKT140 (0.006, 0.03, 0.1, 0.3, and 0.9 mg/kg) was administered subcutaneously on day 10 in the early morning, followed by G-CSF 12 hours later.Results: BKT140 was well tolerated at all concentrations, and none of the patients developed grade 3 and 4 toxicity. A single administration of BKT140 at the highest dose, 0.9 mg/kg, resulted in a robust mobilization and collection of CD34 þ cells (20.6 AE 6.9 Â 10 6

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Section: Discussionmentioning

confidence: 99%

“…However, even with the use of plerixafor, the mobilization of a sufficient number of stem cells remains a difficult objective in a sizeable proportion of patients (41% NHL and 13% patients with multiple myeloma), particularly those treated with lenalidomide or fludarabine as induction therapy (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

The High-Affinity CXCR4 Antagonist BKT140 Is Safe and Induces a Robust Mobilization of Human CD34+ Cells in Patients with Multiple Myeloma

Peled

Abraham

Avivi

et al. 2014

Clinical Cancer Research

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“…Novel agents such as thalidomide, lenalidomide, and, more recently, pomalidomide (IMiD) are now the backbone of treatment for newly diagnosed and relapsed MM. Neutropenia is one of the most common and predictable adverse events occurring during the use of lenalidomide (along with dexamethasone) and is often managed by treatment discontinuation, dose modulation, and/or G-CSF [24,25]. The rates of neutropenia and infections from lenalidomide vary according to the dose of dexamethasone and combination compound used, ranging from 32 to 41% and 8 to 22%, respectively [26].…”

Section: Neutropenia and Fn In Multiple Myelomamentioning

confidence: 99%

Pegfilgrastim for primary prophylaxis of febrile neutropenia in multiple myeloma

Cerchione

Nappi

Martinelli

2021

Support Care Cancer

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Multiple myeloma (MM) survival rates have been substantially increased thanks to novel agents that have improved survival outcomes and shown better tolerability than treatments of earlier years. These new agents include immunomodulating imide drugs (IMiD) thalidomide and lenalidomide, the proteasome inhibitor bortezomib (PI), recently followed by new generation IMID pomalidomide, monoclonal antibodies daratumumab and elotuzumab, and next generation PI carfilzomib and ixazomib. However, even in this more promising scenario, febrile neutropenia remains a severe side effect of antineoplastic therapies and can lead to a delay and/or dose reduction in subsequent cycles. Supportive care has thus become key in helping patients to obtain the maximum benefit from novel agents. Filgrastim is a human recombinant subcutaneous preparation of G-CSF, largely adopted in hematological supportive care as “on demand” (or secondary) prophylaxis to recovery from neutropenia and its infectious consequences during anti-myeloma treatment. On the contrary, pegfilgrastim is a pegylated long-acting recombinant form of granulocyte colony-stimulating factor (G-CSF) that, given its extended half-life, can be particularly useful when adopted as “primary prophylaxis,” therefore before the onset of neutropenia, along chemotherapy treatment in multiple myeloma patients. There is no direct comparison between the two G-CSF delivery modalities. In this review, we compare data on the two administrations’ modality, highlighting the efficacy of the secondary prophylaxis over multiple myeloma treatment. Advantage of pegfilgrastim could be as follows: the fixed administration rather than multiple injections, reduction in neutropenia and febrile neutropenia rates, and, finally, a cost-effectiveness advantage.

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“…По данным E. Pérez Persona и соавт. [99], ФП являлась основной НР со стороны сердечно-сосудистой системы, ассоциированной с применением леналидомида, особенно при длительном его использовании.…”

Section: иммуномодуляторыunclassified

Atrial Fibrillation Associated with Anticancer Drugs

Остроумова

Chernyaeva

Кочетков

et al. 2020

Bezopasnost' i risk farmakoterapii

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Atrial fibrillation is a serious adverse reaction associated with the use of anticancer drugs. The aim of the study was to analyse scientific literature on the prevalence, pathophysiological mechanisms, and risk factors of anticancer drug-induced atrial fibrillation, ways of its prevention and treatment. The results of the study showed that the incidence of drug-induced atrial fibrillation varies depending on a specific anticancer drug and ranges from 1 to 86%. It is associated with the use of herbal anticancer agents, alkylating agents, protein kinase inhibitors, monoclonal antibodies, immunosuppressants, antitumor antibiotics, antimetabolites, hormonal anticancer agents, hormone antagonists, etc. Most often, atrial fibrillation develops following the use of such drugs as gemcitabine (in combination with vinorelbine), cisplatin, melphalan, ibrutinib, cetuximab, trastuzumab, alemtuzumab, and doxorubicin. It was demonstrated that the pathophysiological mechanisms underlying the development of atrial fibrillation induced by anticancer drugs include electrophysiological abnormalities, myocardial injury, inflammation, immune response, apoptosis, and oxidative stress. Risk factors for the development of anticancer drug-induced atrial fibrillation are not clearly defined yet and continue to be the subject of research. Prevention of drug-induced atrial fibrillation in cancer patients requires a multidisciplinary approach involving participation of an oncohematologist and a cardiologist. The doctors in charge should also be vigilant regarding potential development of this adverse reaction.

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Lenalidomide treatment for patients with multiple myeloma: Diagnosis and management of most frequent adverse events

Cited by 14 publications

References 18 publications

The High-Affinity CXCR4 Antagonist BKT140 Is Safe and Induces a Robust Mobilization of Human CD34+ Cells in Patients with Multiple Myeloma

The High-Affinity CXCR4 Antagonist BKT140 Is Safe and Induces a Robust Mobilization of Human CD34+ Cells in Patients with Multiple Myeloma

Pegfilgrastim for primary prophylaxis of febrile neutropenia in multiple myeloma

Atrial Fibrillation Associated with Anticancer Drugs

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