Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus
In Canada, lenalidomide combined with dexamethasone (Len/Dex) is approved for use in relapsed or refractory multiple myeloma (RRMM). Our expert panel sought to provide an up-to-date practical guide on the use of lenalidomide in the managing RRMM within the Canadian clinical setting, including manage...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2012/621958 |
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| author | Donna Reece C. Tom Kouroukis Richard LeBlanc Michael Sebag Kevin Song John Ashkenas |
| author_facet | Donna Reece C. Tom Kouroukis Richard LeBlanc Michael Sebag Kevin Song John Ashkenas |
| author_sort | Donna Reece |
| collection | DOAJ |
| description | In Canada, lenalidomide combined with dexamethasone (Len/Dex) is approved for use in relapsed or refractory multiple myeloma (RRMM). Our expert panel sought to provide an up-to-date practical guide on the use of lenalidomide in the managing RRMM within the Canadian clinical setting, including management of common adverse events (AEs). The panel concluded that safe, effective administration of Len/Dex treatment involves the following steps: (1) lenalidomide dose adjustment based on creatinine clearance and the extent of neutropenia or thrombocytopenia, (2) dexamethasone administered at 20–40 mg/week, and (3) continuation of treatment until disease progression or until toxicity persists despite dose reduction. Based on available evidence, the following precautions should reduce the risk of common Len/Dex AEs: (1) all patients treated with Len/Dex should receive thromboprophylaxis, (2) erythropoiesis-stimulating agents (ESAs) should be used cautiously, and (3) females of child-bearing potential and males in contact with such females must use multiple contraception methods. Finally, while Len/Dex can be administered irrespective of prior therapy and in all prognostic subsets, patients with chromosomal deletion 17(p13) have less favorable outcomes with all treatments, including Len/Dex. New directions for the use of lenalidomide in RRMM are also considered. |
| format | Article |
| id | doaj-art-03aea1ddfb3843c5911f4becc4e61ef9 |
| institution | OA Journals |
| issn | 1687-9104 1687-9112 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Hematology |
| spelling | doaj-art-03aea1ddfb3843c5911f4becc4e61ef92025-08-20T02:03:19ZengWileyAdvances in Hematology1687-91041687-91122012-01-01201210.1155/2012/621958621958Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian ConsensusDonna Reece0C. Tom Kouroukis1Richard LeBlanc2Michael Sebag3Kevin Song4John Ashkenas5Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, CanadaDepartment of Oncology, Juravinski Cancer Centre, 699 Concession Street, Hamilton, ON, L8V 5C2, CanadaHôpital Maisonneuve-Rosemont, University of Montreal, Montreal, QC, H1T 2M4, CanadaMcGill University Health Centre, McGill University, Montreal, QC, H3A 1A1, CanadaLeukemia/BMT Program of British Columbia, Vancouver General Hospital, Vancouver, BC, V5Z 1M9, CanadaSCRIPT, Toronto, ON, M4S 1Z9, CanadaIn Canada, lenalidomide combined with dexamethasone (Len/Dex) is approved for use in relapsed or refractory multiple myeloma (RRMM). Our expert panel sought to provide an up-to-date practical guide on the use of lenalidomide in the managing RRMM within the Canadian clinical setting, including management of common adverse events (AEs). The panel concluded that safe, effective administration of Len/Dex treatment involves the following steps: (1) lenalidomide dose adjustment based on creatinine clearance and the extent of neutropenia or thrombocytopenia, (2) dexamethasone administered at 20–40 mg/week, and (3) continuation of treatment until disease progression or until toxicity persists despite dose reduction. Based on available evidence, the following precautions should reduce the risk of common Len/Dex AEs: (1) all patients treated with Len/Dex should receive thromboprophylaxis, (2) erythropoiesis-stimulating agents (ESAs) should be used cautiously, and (3) females of child-bearing potential and males in contact with such females must use multiple contraception methods. Finally, while Len/Dex can be administered irrespective of prior therapy and in all prognostic subsets, patients with chromosomal deletion 17(p13) have less favorable outcomes with all treatments, including Len/Dex. New directions for the use of lenalidomide in RRMM are also considered.http://dx.doi.org/10.1155/2012/621958 |
| spellingShingle | Donna Reece C. Tom Kouroukis Richard LeBlanc Michael Sebag Kevin Song John Ashkenas Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus Advances in Hematology |
| title | Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus |
| title_full | Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus |
| title_fullStr | Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus |
| title_full_unstemmed | Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus |
| title_short | Practical Approaches to the Use of Lenalidomide in Multiple Myeloma: A Canadian Consensus |
| title_sort | practical approaches to the use of lenalidomide in multiple myeloma a canadian consensus |
| url | http://dx.doi.org/10.1155/2012/621958 |
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