Lenalidomide, an immunomodulating agent with the brand name Revlimid, is a new therapy for multiple myeloma. It is most often used with chemotherapy for patients who have relapsed after initial treatment. Although it is chemically similar to thalidomide, lenalidomide is formulated to be less toxic. Most side effects are manageable and predictable, however, a few potentially serious side effects require immediate medical attention, according to the "New England Journal of Medicine."
Decreased Platelets
Reduced platelet levels in the blood, a condition known as thrombocytopenia, leads to excessive or easy bruising, unusual bleeding, and slow healing. According to the International Myeloma Foundation, doctors may recommend a platelet transfusion to manage thrombocytopenia.
Decreased White Blood Cells
Another fairly common side effect of lenalidomide is neutropenia, reduced white blood cells in the blood. Signs are fever and frequent infection, both of which mandate prompt medical attention. A sore throat or mouth sores may appear, causing patients to think they simply have a cold. Doctors initiate treatment if neutropenia is severe.
Blood Clots in Veins or Lungs
Shortness of breath, chest pain and arm or leg swelling may be signs of a blood clot and require contact with a physician right away. How the blood clot is treated depends on its location and cause. Blood thinners may be prescribed to prevent the clot from getting larger.
Potential for Birth Defects
Because lenalidomide may cause defects or even the death of an unborn baby, women must not get pregnant while they take this medication, including for 4 weeks before and after treatment. Because researchers do not know if lenalidomide passes into semen, so men must refrain from unprotected sexual contact with women who may become pregnant. Due to this risk, the FDA recommends that people taking lenalidomide do not donate blood or sperm.
Other Common Effects
Common side effects of lenalidomide include diarrhea, which may last more than a few days, and mild constipation. Insomnia, rash, and muscle cramps also occur frequently. Fatigue is commonly associated with lenalidomide as well. It is not harmful, although caution should be exercised while driving.
References
- Revlimid: Understanding Side Effects
- International Myeloma Foundation: Understanding Revlimid
- FDA: Medication Guide: Revlimid
- Lenalidomide plus desamethasone for relapsed or refractory multiple myeloma. N Engl J Med. 2007.
