| Management |
Agents that are known to cause thrombosis should be used with caution in multiple myeloma patients receiving lenalidomide with dexamethasone. Patients should be advised to seek medical attention if they develop potential signs and symptoms of thromboembolism such as chest pain shortness of breath rapid pulse pain, swelling, and/or discoloration in an arm or leg and numbness or weakness on one side of the body. It is not known whether prophylactic anticoagulation or antiplatelet therapy may lessen the risk of venous thromboembolic events. The decision to take prophylactic measures should be done carefully after a thorough assessment of underlying risk factors. If a thromboembolic event occurs during therapy with lenalidomide, treatment must be discontinued and standard anticoagulation therapy initiated. Once anticoagulation is stabilized and complications of the thromboembolic event under control, lenalidomide may be restarted at the original dose if benefit is deemed to outweigh the risks. Anticoagulation therapy should be continued during the remaining course of lenalidomide treatment. |
