Pomalidomide re-exposure after drug-related severe hypothyroidism: a case report

Pomalidomide, an analogue of lenalidomide and thalidomide, has shown significant activity in treating relapsed refractory multiple myeloma (MM). Due to its oral formulation and favorable safety profile, pomalidomide is generally well tolerated, even among elderly and frail patients. We present a case of severe hypothyroidism induced by pomalidomide in a 71-year-old woman with relapsing/refractory MM. After initiating levothyroxine therapy, her symptoms quickly resolved. We then attempted to resume pomalidomide treatment; the rechallenge proved safe concerning thyroid function. In conclusion, we recommend testing thyroid function in patients prior to and then every 2–3 months during pomalidomide treatment. If drug-induced hypothyroidism occurs, once the patient reaches a state of euthyroidism, a rechallenge can be considered with a good safety profile.