Part of the IMF Patient Education Tools Series
Managing Myelosuppression From Novel Agents for Multiple Myeloma
Patient Education Sheet: Managing Myelosuppression From Novel Agents for Multiple Myeloma
The greatest concern with neutropenia is infection. Symptoms
KEY POINTS
can include fever of 100.5°F (38°C) or higher, shaking chills,
dizziness, fainting, redness at a wound site, difficulty breath-
Novel therapies used to treat multiple myeloma include
ing, cough, or sinus congestion.
thalidomide, lenalidomide, and bortezomib. The drugs can
cause myelosuppression, which is a decrease in bone mar-
If you experience fever or symptoms of infection, contact your
row activity, resulting in fewer red blood cells (anemia),
healthcare provider immediately.
white blood cells (neutropenia), and platelets (thrombocy-
topenia). The risk of side effects varies with each medica-
To reduce your risk of infection, wash your hands carefully
tion. Managing the side effects can reduce your discomfort,
and often, avoid crowds, and take antibiotics as prescribed by
prevent serious complications, and allow you to receive the
your healthcare provider.
best treatment for your myeloma. Your healthcare provider
may change your dose or schedule of medication to help
Your healthcare provider will check your blood counts regu-
manage your symptoms. Do not stop or adjust medications
larly based on your plan of care and may prescribe antibiotics
without discussing it with your healthcare provider.
to prevent infection and growth factors to stimulate white
blood cell growth. If necessary, changes may be made to
ANEMIA
medications you are taking.
Anemia is a decrease in red blood cells, or hemoglobin, which
THROMBOCYTOPENIA
carry oxygen in the blood. It may result from myeloma treat-
ment, decreased kidney function, myeloma disease, or other
Thrombocytopenia is a decrease in platelets that protect
medications.
against bleeding. It may result from myeloma treatment,
Symptoms of anemia can include fatigue, low energy level,
myeloma disease, or other medications. It may be associated
difficulty with normal daily activities, shortness of breath with
more frequently with lenalidomide and bortezomib.
activity, and chest pain with activity.
Symptoms of thrombocytopenia may include bruising, pink
If you experience symptoms of anemia, contact your health-
urine, nosebleeds, small red or purple spots on the body
care provider.
(petechiae), and bleeding that does not stop with pressure.
Try not to use too much energy in daily activities.
If you experience signs or symptoms of a low platelet count,
contact your healthcare provider immediately.
Your healthcare provider may prescribe a red blood cell
supplement such as iron, erythropoietin, or a red blood cell
To reduce your risk of bruising or bleeding, avoid taking as-
transfusion. If necessary, changes may be made in medica-
pirin, ibuprofen, or naproxen. Avoid activities that can cause
tions you are taking.
bruising or bleeding, such as contact sports, anal sex, and
heavy lifting. Participate in gentle exercise only.
NEUTROPENIA
Your healthcare provider will monitor blood counts regularly
Neutropenia is a decrease in white blood cells, which protect
based on your plan of care and may prescribe a platelet
against infection. It may result from myeloma treatment, my-
transfusion. If necessary, changes may be made in medica-
eloma disease, or other medications.
tions you are taking.
Note. For more information, please contact the International Myeloma Foundation (1-800-452-CURE; www.myeloma.org). The foundation offers the
Myeloma ManagerTM Personal Care AssistantTM computer program to help patients and healthcare providers keep track of information and treatments.
Visit http://manager.myeloma.org to download the free software.
Note. Patient education sheets were developed in June 2008 based on the International Myeloma Foundation Nurse Leadership Board's consensus
guidelines. They may be reproduced for noncommercial use.
Reprint · June 2008 · Supplement to Volume 12, Number 3 · Clinical Journal of Oncology Nursing

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