As Revlimid (lenalidomide) and Velcade (bortezomib) have become standard therapies in the treatment of multiple myeloma, managing side effects is important for patients who want to maintain their treatment while minimizing toxicity.

A recent report published in the journal Community Oncology discusses the management of side effects associated with these agents. Overall, the most commonly observed toxic effects include myelosuppression, gastrointestinal effects, peripheral neuropathy, and thromboembolic events.

Myelosuppression is a condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Revlimid …

Numerous treatment options are available to multiple myeloma patients, with the therapeutic objective of inducing complete remission (CR) or at least very good partial remission (VGPR).

In the American Society of Hematology's recent Education Program Book, "Hematology," researcher Jean-Luc Harousseau compares treatment regimens with and without a stem cell transplant component. In addition, he examines the mounting belief that complete remission, a potentially unreliable prognostic indicator, should cease to be the therapeutic goal in all situations.

Comparison: Treatment With and Without Stem Cell Transplant

During initial treatment after …

The Scottish Medicines Consortium (SMC) has relaxed a 48-year old ban on thalidomide (Thalomid) following a recommendation by the European Medicines Agency, a pharmaceutical regulatory resource.  This decision approves the use of thalidomide for first-line treatment of multiple myeloma in combination with melphalan and prednisone, and is restricted to patients over 65 or who cannot receive high-dose chemotherapy.

Patients in a recent study experienced an overall survival advantage of 18.4 months when treated with thalidomide with melphalan and prednisone.  The SMC, which measures drugs …

For more than four decades, the standard of care in elderly multiple myeloma patients over age 65 has been a combination of melphalan (a chemotherapy drug) and prednisone (a steroid). Yet, this regimen, known as MP, only achieves a five percent complete remission rate.

The advent of novel therapeutic agents has greatly improved treatment outcomes.

Multiple researchers have tested an MP plus thalidomide (Thalomid) regimen, or MPT, and the majority of these studies have found that MPT yields superior complete remission (CR), very good partial remission (VGPR), and progression-free survival rates, …

Steroids such as dexamethasone and prednisone are frequently used to treat myeloma patients. They reduce swelling and inflammation and have been shown to kill myeloma cells. However, steroids can also cause many serious side effects.

Both dexamethasone and prednisone can be prescribed alone or in combination with novel anti-myeloma drugs, which include thalidomide (Thalomid), Revlimid (lenalidomide), and Velcade (bortezomib). Prednisone is also used to enhance the response rate of melphalan therapy in myeloma patients.

Side effects caused by these steroids include, but are not limited to, …

In young patients under age 65, stem cell transplants have greatly reduced remission rates when coupled with novel therapeutic agents (thalidomide, Velcade, and Revlimid).

Unlike elderly patients, younger individuals are usually healthy enough to withstand an intensive course of high-dose chemotherapy. The chemotherapy, while a potent killer of cancerous cells, also destroys bone marrow, therefore necessitating a transplant after treatment. In conjunction with high-dose therapy and transplant, the introduction of novel agents has further improved complete remission (CR), very good partial remission (VGPR), and progression-free survival (PFS) rates. …

A large-scale, retrospective study has confirmed an increased risk of deep vein thrombosis (DVT) with multiple myeloma or its precursor condition, monoclonal gammopathy of undetermined significance (MGUS).

DVT is a potentially lethal clot formation in the deep veins of the body. If a clot dislodges, it may travel to other areas and block blood flow to vital organs. Researchers estimate that approximately 70 percent of all critical blockages of lung blood vessels originate from DVT in the pelvis or lower extremities.

In this study, which involved over four million male veterans, multiple …