Lenalidomide: Patient Management Strategies

Experience with thalidomide has underscored the need for diligent monitoring and management of side effects to achieve optimal therapeutic benefit. Initial phase II and III results with lenalidomide, a thalidomide analogue, have confirmed impressive response rates with a significantly more favorable toxicity profile. The Cleveland Clinic experience with lenalidomide alone or in combination with pegylated liposomal doxorubicin, vincristine, and reduced schedule dexamethasone will be described. Peripheral neuropathy and deep venous thrombosis (DVT). Low-dose aspirin alleviated DVT when lenalidomide was used in combination with anthracycline-containing chemotherapy. Strategies for managing these toxicities and for recognition and management of lenalidomide-associated myelosuppression are reviewed.