BSH 2022 | Safety of lenalidomide maintenance therapy in myeloma patients following transplantation
In this video, Graham Jackson, MBBS, FRCP, FRCPath, MD, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK, discusses the safety of lenalidomide maintenance therapy in patients with multiple myeloma following transplantation. Prof. Jackson highlights the importance of ensuring that maintenance therapy causes minimal toxicity, and further explains some of the toxicities to look out for, including neutropenia, thrombocytopenia, and secondary primary malignancies. This interview took place at the 62nd Annual Scientific Meeting of the British Society for Haematology (BSH) 2022, in Manchester, UK.
Transcript (edited for clarity)
It’s a good question around the safety of Revlimid maintenance. Clearly we use Revlimid maintenance in the first remission post-transplant. So our patients by this time are usually in a very good response from their multiple myeloma. This is a period of time when they have very good quality of life. So it’s very, very important that whatever maintenance strategy we use, we use it with the minimum of toxicity...
It’s a good question around the safety of Revlimid maintenance. Clearly we use Revlimid maintenance in the first remission post-transplant. So our patients by this time are usually in a very good response from their multiple myeloma. This is a period of time when they have very good quality of life. So it’s very, very important that whatever maintenance strategy we use, we use it with the minimum of toxicity.
What are the toxicities you need to look out for? Well, hematological toxicity and neutropenia and thrombocytopenia are key issues that you need to manage with dose adjustments with G-CSF. We’re aware that some patients get fatigue and that can be an issue for patients. And some patients come off maintenance because of fatigue.
Some patients get some early morning diarrhea, which is something you also have to watch out for. We don’t in the maintenance setting so much see many other adverse effects. One of the side effects that we need to watch out for though is secondary primary malignancies. There is evidence there is a slight increased risk. I will emphasize slight or very minor increased risk. But nevertheless, myeloma patients who’ve had frontline therapy, transplant and Revlimid maintenance we should, when we’re seeing them, have half a thought about making sure they’re not developing another malignancy, as well as their myeloma.
Read more...
Disclosures
Speaker honoraria engagements: Amgen, Takeda, Johnson & Johnson, Sanofi, Celgene and Roche; Research funding: Takeda, Onyx and Celgene; Advisory Boards: Amgen, Takeda, Johnson & Johnson, Oncopeptides, Pfizer, Sanofi, Celgene, GSK and Roche; Board of directors Myeloma UK.
