Open Access Article
Article

Steroid-Associated Side Effects in Patients With Multiple Myeloma: Consensus Statement of the IMF Nurse Leadership Board

Beth Faiman

Elizabeth Bilotti

Patricia Mangan

Kathryn Rogers

steroids
CJON 2008, 12(3), 53-62. DOI: 10.1188/08.CJON.S1.53-62

Steroids have been the foundation of multiple myeloma therapy for more than 30 years and continue to be prescribed as single agents and in combination with other antimyeloma drugs, including novel therapies. Steroids cause a wide range of side effects that affect almost every system of the body. Identification and prompt management of the toxicities contribute to the success of steroid-containing antimyeloma regimens. By following patients carefully and educating them and their caregivers, nurses can promote adherence to therapy and improve quality of life. The International Myeloma Foundation's Nurse Leadership Board developed this consensus statement for the management of steroid-associated side effects to be used by healthcare providers in any medical setting.

Jump to a section

    References

    Alexanian, R., Dimopoulos, M. A., Delasalle, K., & Barlogie, B. (1992). Primary dexamethasone treatment of multiple myeloma. Blood, 80(4), 887-890.
    Alexanian, R., Haut, A., Khan, A. U., Lane, M., McKelvey, E. M., Migliore, P. J., et al. (1969). Treatment for multiple myeloma. Combination chemotherapy with different melphalan dose regimens. JAMA, 208(9), 1680-1685.
    American Diabetes Association. (2007). All about diabetes. Retrieved October 23, 2007, from http://www.diabetes.org/about-diabetes.jsp
    Arlt, W., & Allolio, B. (2003). Adrenal insufficiency. Lancet, 361(9372), 1881-1893.
    Badger, T. A., Fulcher, C. D., Gunter, A. K., Marrs, J., & Reese, J. (2007). Putting Evidence Into Practice®: Depression. Retrieved September 10, 2007, from http://www.ons.org/outcomes/volume2/depression.shtml
    Celgene Corporation. (2007a). Revlimid® (lenalidomide) [Package indert]. Summit, NJ: Author.
    Celgene Corporation. (2007b). Thalomid® (thalidomide) [Package insert]. Summit, NJ: Author.
    Cerullo, M. A. (2006). Corticosteroid-induced mania: Prepare for the unpredictable. Current Psychiatry, 5(6), 43-50.
    Colson, K., Doss, D. S., Swift, R., Tariman, J., & Thomas, T. E. (2004). Bortezomib, a newly approved proteasome inhibitor for the treatment of multiple myeloma: Nursing implications. Clinical Journal of Oncology Nursing, 8(5), 473-480.
    Dawson-Hughes, B., Harris, S. S., Krall, E. A., & Dallal, G. E. (1997). Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. New England Journal of Medicine, 337(10), 670-676.
    Del Valle, J. (2005). Peptic ulcer disease and related disorders. In D. L. Kasper, E. Braunwald, D. Longo, J. L. Jameson, A. S. Fauci, & S. L. Hauser (Eds.), Harrison's principles of internal medicine (16th ed.). New York: McGraw-Hill.
    Doty, R. L., & Bromley, S. M. (2004). Effects of drugs on olfaction and taste. Otolaryngologic Clinics of North America, 37(6), 1229-1254.
    Groeneveldt, L. J., Garrod, R., Yong, K. L., Dangwa, F., Jewell, A. P., van Someren, K., et al. (2007). An exercise training programme produces significant improvements in quality of life (QoL), muscle strength and cardiorespiratory function in patients with myeloma [Abstract]. Blood, 110(11), 3323.
    Guise, T. A. (2006). Bone loss and fracture risk associated with cancer therapy. Oncologist, 11(10), 1121-1131.
    Jackson, R. D., LaCroix, A. Z., Gass, M., Wallace, R. B., Robbins, J., Lewis, C. E., et al. (2006). Calcium plus vitamin D supplementation and the risk of fractures. New England Journal of Medicine, 354(8), 669-683.
    Lindsay, R., & Cosman, F. (2005). Osteoporosis. In D. L. Kasper, E. Braunwald, D. Longo, J. L. Jameson, A. S. Fauci, & S. L. Hauser (Eds.), Harrison's principles of internal medicine (16th ed.). New York: McGraw-Hill.
    Lips, P., Graafmans, W. C., Ooms, M. E., Bezemer, P. D., & Bouter, L. M. (1996). Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Annals of Internal Medicine, 124(4), 400-406.
    MacArthur Initiative on Depression and Primary Care at Dartmouth and Duke. (2003-2006). Depression tool kit. Retrieved September 25, 2007, from http://www.depression-primarycare.org/clinicians/toolkits/
    Merck & Co., Inc. (2004). Decadron® (dexamethasone) [Package insert]. Whitehouse Station, NJ: Author.
    Miceli, T., Colson, K., Gavino, M., Lilleby, K., & the IMF Nurse Leadership Board. (2008). Myelosuppression associated with novel therapies in patients with multiple myeloma: Consensus statement of the IMF Nurse Leadership Board. Clinical Journal of Oncology Nursing, 12(3, Suppl.), 13-19.
    Millennium Pharmaceuticals, Inc. (2007). Velcade® (bortezomib) [Package insert]. Cambridge, MA: Author.
    Mitchell, S., Beck, S., Hood, L., Moore, K., & Tanner, E. (2006). Putting Evidence Into Practice®: Fatigue. Retrieved September 10, 2007, from http://www.ons.org/outcomes/volume1/fatigue.shtml
    National Cancer Institute. (2006). Common Terminology Criteria for Adverse Events v.3.0. Retrieved December 28, 2007, from http://ctep.cancer.gov/forms/CTCAEv3.pdf
    National Institutes of Mental Health. (2007). Health and outreach topics: Depression. Retrieved September 25, 2007, from http://www.nimh.nih.gov/healthinformation/depressionmenu.cfm
    National Library of Medicine & National Institutes of Health. (2007). Erectile dysfunction. Retrieved September 25, 2007, from http://www.nlm.nih.gov/medlineplus/erectiledysfunction.html
    Page, M. S., Berger, A. M., & Johnson, L. B. (2006). Putting Evidence Into Practice®: Sleep-wake disturbances. Retrieved September 10, 2007, from http://www.ons.org/outcomes/volume1/sleep.shtml
    Pogach, L. M., Brietzke, S. A., Cowan, C. L., Conlin, P., Walder, D. J., & Sawin, C. T. (2004). Development of evidence-based clinical practice guidelines for diabetes: The Department of Veterans Affairs/Department of Defense guidelines initiative. Diabetes Care, 27(Suppl. 2), B82-B89.
    Rajkumar, S. V. (2007). The role of lenalidomide in myeloma patients eligible for high dose therapy. Haematologica, 92(Suppl. 2), 30-32.
    Rajkumar, S. V., Jacobus, S., Callander, N., Fonseca, R., Vesole, D., & Griepp, P. (2006). A randomized phase III trial of lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone in newly diagnosed multiple myeloma (E4A03): A trial coordinated by the Eastern Cooperative Oncology Group [Abstract]. Blood, 108(11), 799.
    Rajkumar, S. V., Jacobus, S., Callander, N., Fonseca, R., Vesole, D., Williams, M., et al. (2007). Phase III trial of lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone in newly diagnosed multiple myeloma (E4A03): A trial coordinated by the Eastern Cooperative Oncology Group [Abstract]. 2007 ASCO Annual Meeting Proceedings Part I. Journal of Clinical Oncology, 25(18, Suppl.), 8025.
    Rome, S., Doss, D. S., Miller, K. C., Westphal, J., & the IMF Nurse Leadership Board. (2008). Thromboembolic events associated with novel therapies in patients with multiple myeloma: Consensus statement of the IMF Nurse Leadership Board. Clinical Journal of Oncology Nursing, 12(3, Suppl.), 21-27.
    Sambrook, O. N. (2005). How to prevent steroid induced osteoporosis. Annals of the Rheumatic Diseases, 64(2), 176-178.
    Smith, L. C., Bertolotti, P., Curran, K., Jenkins, B., & the IMF Nurse Leadership Board. (2008). Gastrointestinal intestinal side effects associated with novel therapies in patients with multiple myeloma: Consensus statement of the IMF Nurse Leadership Board. Clinical Journal of Oncology Nursing, 1212(3, Suppl.), 37-51.
    Talamo, G., Angtuaco, E., Walker, R. C., Dong, L., Miceli, M. H., Zangari, M., et al. (2005). Avascular necrosis of femoral and/or humeral heads in multiple myeloma: Results of a prospective study of patients treated with dexamethasone-based regimens and high-dose chemotherapy. Journal of Clinical Oncology, 23(22), 5217-5223.
    Tariman, J. D., & Estrella, S. M. (2005). The changing treatment paradigm in patients with newly diagnosed multiple myeloma: Implications for nursing [Online exclusive]. Oncology Nursing Forum, 32(6), E127-E138. Retrieved March 26, 2008, from http://www.ons.org/publications/journals/ONF/Volume32/Issue6/32061098.a… http://www.ons.org/publications/journals/ONF/Volume32/Issue6/32061098.asp
    U. S. Food and Drug Administration. (2006). FDA advances effort against marketed unapproved drugs. Retrieved October 23, 2007, from http://www.fda.gov/bbs/topics/NEWS/2006/NEW01521.html
    Watson Laboratories, Inc. (2006). Prednisolone (prednisolone) [Package insert]. Corona, CA: Author.
    Wilson, T. A., & Speiser, P. (2007). Adrenal insufficiency. Retrieved October 23, 2007, from http://www.emedicine.com/PED/topic47.htm
    Woo-Ming, M. A. (2007). Hiccups. Retrieved September 25, 2007, from http://www.emedicinehealth.com/hiccups/article_em.htm
    Berenson, J. R., Crowley, J. J., Grogan, T. M., Zangmeister, J., Briggs, A. D., Mills, G. M., et al. (2002). Maintenance therapy with alternate-day prednisone improves survival in multiple myeloma patients. Blood, 99(9), 3163-3168.
    Bertolotti, P., Bilotti, E., Colson, K., Curran, K., Doss, D., Faiman, B., et al. (2007). Nursing guidelines for enhanced patient care. Haematologica, 92(Suppl. 2), 211.
    Bertolotti, P., Bilotti, E., Colson, K., Curran, K., Doss, D., Faiman, B., et al. (2008). Management of side effects of novel therapies for multiple myeloma: Consensus statements developed by the International Myeloma Foundation's Nurse Leadership Board. Clinical Journal of Oncology Nursing, 12(3, Suppl.), 9-12.
    Zitella, L., Friese, C., Gobel, B. H., Woolery-Antill, M., O'Leary, C., Hauser, J., et al. (2006). Putting Evidence Into Practice®: Prevention of infection. Retrieved October 23, 2007, from http://www.ons.org/outcomes/PEPcard/prevention.shtml