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Common side effects include sleepiness, rash, and dizziness. [6] Severe side effects include tumor lysis syndrome, blood clots, and peripheral neuropathy. [8] Thalidomide is a known human teratogen and carries an extremely high risk of severe, life-threatening birth defects if administered or taken during pregnancy. [6]
Adverse effects by frequency: [1] [2] Note that teratogenicity is not discussed here as it is not considered a side effect. For information regarding birth defects, see thalidomide .
The problems with thalidomide included teratogenic side effects, high incidence of other adverse reactions, poor solubility in water and poor absorption from the intestines. In 1998 thalidomide was approved by the U.S. Food and Drug Administration (FDA) for use in newly diagnosed multiple myeloma (MM) under strict regulations. [2]
MGUS is a relatively stable condition afflicting 3% of people aged 50 and 5% of people aged 70; it progresses to multiple myeloma at a rate of 0.5–1% cases per year; smoldering multiple myeloma does so at a rate of 10% per year for the first 5 years, but then falls off sharply to 3% per year for the next 5 years and thereafter to 1% per year.
Thalidomide brought on changes in the way drugs are tested, what type of drugs are used during pregnancy, and increased the awareness of potential side effects of drugs. According to Canadian news magazine programme W5 , most, but not all, victims of thalidomide receive annual benefits as compensation from the Government of Canada .
The best prognosis is seen with RA and RARS, where some nontransplant patients live more than a decade (typical is on the order of three to five years, although long-term remission is possible if a bone-marrow transplant is successful). The worst outlook is with RAEB-T, where the mean life expectancy is less than one year.
Severe side effects include low blood platelets, low white blood cells, and blood clots. [8] The dose may need to be adjusted in people with kidney problems. [8] Lenalidomide is closely related to thalidomide, which is known to cause severe birth defects, so its use during pregnancy is very likely to harm the fetus. [8]
Tyrosine kinase inhibitors like imatinib have improved the prognosis of CML patients to near-normal life expectancy. [14] Recently, a JAK2 inhibitor, namely ruxolitinib, has been approved for use in primary myelofibrosis. [15] Trials of these inhibitors are in progress for the treatment of the other myeloproliferative neoplasms.
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