Avaliação e classificação de reações adversas a medicamentos antineoplásicos em pacientes portadores de mieloma múltiplo

Abstract

Introduction: Multiple myeloma is responsible for approximately 1% of all malignant neoplasms and 13% of neoplasms of hematological origin. There are several adverse effects that occur in various chemotherapy protocols, and it is essential to carefully monitor patients for possible adverse reactions in order to avoid complications that could compromise the therapeutic outcome. Objective: To evaluate and classify the main adverse drug reactions (ADRs) in the treatment of patients with multiple myeloma. Methodology: This is an observational and prospective study carried out in a private institution that treats patients from the ‘Sistema Único de Saúde’ (SUS) and private health insurance plans. Data was collected from 46 patients through pharmaceutical anamneses between March of 2022 and December of 2023. The patients included were assigned to 12 different types of chemotherapy protocols. The ‘Guia para Notificação de Reações Adversas em Oncologia da Sociedade Brasileira de Farmacêuticos em Oncologia’ (SOBRAFO) was used to evaluate and classify the ADRs reported by the patients, and the data was treated by frequency through plotting in an Excel spreadsheet. Results: There was a predominance of males (57%) compared to females (43%). The average age was 65 ± 9.8 years. Of the 144 interviews evaluated, 36 different ADRs were recorded. The main reactions were: fatigue (10.6%), paresthesia (10.2%), nausea (9.5%) and dry skin (7.9%). The main ADRs reported were grade I and II and were mainly related to the bortezomib, cyclophosphamide, dexamethasone (VCD) and daratumumab, bortezomib and dexamethasone (DARA-VD) protocols. There were grade III reactions (4%) associated with the carfilzomib, lenalidomide and dexamethasone (KRD), bortezomib, melphalan and prednisone (VMP), DARA-VD and VCD protocols. Conclusion: According to the results, the main reactions identified were fatigue and paresthesia. In terms of classification, mild and moderate ADRs were the most frequent and the protocols most involved in the reported ADRs and of greatest importance were DARA-VD and VCD. It is therefore important to monitor adverse reactions in the interests of safety and compliance with therapeutic protocols.