High incidence of chemo-related ADRs noted in multiple myeloma patients

A single-institution study has found a notably high incidence of chemotherapy-related adverse drug reactions (ADRs) in patients with multiple myeloma.

The total number of ADRs reported was 230, with a prevalence of 81.5 percent. Peripheral neuropathy (21.7 percent) was the most common ADR, followed by nausea and vomiting (14.8 percent), neutropenia (12.2 percent), and anaemia (11.3 percent). More than half of the ADRs (51.7 percent) were moderate in severity, while a few (29.8 percent) were mild.

Assessment of ADRs revealed that the majority of these (68.2 percent) were preventable, and some (13.2 percent) were probably preventable.

Most of the ADRs can be attributed to VRD (bortezomib/lenalidomide/dexamethasone) and VCD (bortezomib/cyclophosphamide/dexamethasone) treatment regimens. Both VRD (adjusted odds ratio [aOR], 11.1, 95 percent confidence interval [CI], 3.7–32.8; p<0.001) and VCD therapies (aOR, 4.8, 95 percent CI, 1.1–20.0; p=0.033) were significantly associated with the occurrence of ADRs.

“Despite the moderate severity of the ADRs, their preventable nature highlights the potential for improved patient outcomes through careful regimen selection and monitoring,” the investigators said. 

Adult patients with a documented diagnosis of multiple myeloma between 1 January 2017 and 31 December 2023 were included in this one-arm retrospective cohort study. Sociodemographics, clinical characteristics, and chemotherapy-related ADRs were assessed using a data abstraction tool.

The investigators used the Schumock and Thornton scale and the modified Hartwig and Siegel severity scale to assess the preventability and severity of ADRs, respectively. They also used the SPSS version 29.0 software for the data analysis and presented the results using mean, frequency, and percentage. Finally, factors affecting ADRs were identified using binary logistic regression.