Dose Modification for Pomalyst for Hematologic Toxicity
Side Effect Modification of Dose and Regimen
Neutropenia (low levels of neutrophils, a type of white blood cell)
ANC* < 500 per mcL or febrile neutropenia (fever of 38.5°C or higher and ANC < 1,000 per mcL) Interrupt Pomalyst treatment, follow complete blood count weekly
ANC return to more than or equal to 500 per mcL Resume Pomalyst at 3 mg daily
For each subsequent drop < 500 per mcL Interrupt Pomalyst treatment
Return to more than or equal to 500 per mcL Resume Pomalyst at 1 mg less than the previous dose
Thrombocytopenia (low platelet count)
Platelets < 25,000 per mcL Interrupt Pomalyst treatment, follow complete blood count weekly
Platelets return to > 50,000 per mcL Resume Pomalyst treatment at 3 mg daily
For each subsequent drop < 25,000 per mcL Interrupt Pomalyst treatment
Return to more than or equal to 50,000 per mcL Resume Pomalyst at 1 mg less than previous dose.

 

*ANC stands for Absolute Neutrophil Count; mcL stands for microliter.

For other serious side effects, Pomalyst is stopped until the toxicity has resolved or been reduced. At that point, Pomalyst is restarted at 1 mg less than the previous dose.

Before a new cycle of Pomalyst is started, the neutrophil count must be at least 500 per mcL and the platelet count must be at least 50,000 per mcL.