Chemo ADRs

Question 1

Capecitabine ADRs

Answer 1

Hand-foot syndrome characterized by hand and foot erythema w/ epidermal desquamation

Question 2

Daratumumab (Darzalex) ADRs

Answer 2

HBV reactivation - requires HbC ag and antibody testing and concurrent treatment w/ entecavir 0.5mg daily if present

BM suppression - look out for developing cytopenias and febrile neutropenias

Question 3

Carfilzomib (Kyprolis) ADRs

Answer 3

Thrombocytopenia: Platelets reach nadirs between Day 8 and 15 of each cycle; monitor for hemorrhage

Cardiac overload: Monitor closely for volume overload; patients w/ NYHA Class III or IV symptoms, recent MI, angina, or cardiac arryhthmias were excluded from trials

Hypertension

Infusion related rigors, rash, fever

PRESS, PML, TLS

Question 4

Ixazomib (Ninvalo) ADRs

Answer 4

Thrombocytopenia: Platelets typically recover by Day14-21 of the cycle

GI toxicity

Peripheral edema and neuropathy

Hepatotoxicity

Rare TTP

Question 5

Lenalidomide (Revlimid) ADRs

Answer 5

BM suppression: 80% of patients with -5q deletion experience this and may require dose reductions; monitor CBCs AT LEAST weekly for the first two cycles even if they are tolerating it -space out with later cycles

Severe rashes

Hepatotoxicity

***Increased risk for thromboses

Question 6

Bortezomib (Velcade) ADRs

Answer 6

BM suppression: Risk greatest for pts w/ preinfusion count of <75

Acute exacerbation of HF

Herpes reactivation -treat w/ acyclovir 400mg BID

Peripheral neuropathy, PRESS, PML, TLS

Question 7

Pomalidomide (Pomalyst)

Answer 7

BM suppression - most common in first 8 weeks of therapy

DVT/PE

Hepatotoxicity/Rash