PURPOSE: We performed a prospective phase II study to assess the activity of thalidomide in patients with Waldenstrom's macroglobulinemia (WM). PATIENTS AND METHODS: Twenty patients with WM were treated with thalidomide at a starting dose of 200 mg daily with dose escalation in 200-mg increments every 14 days as tolerated to a maximum of 600 mg. All patients were symptomatic, their median age was 74 years, and 10 patients were previously untreated. RESULTS: On an intent-to-treat basis, five (25%) of 20 patients achieved a partial response after treatment. Responses occurred in three of 10 previously untreated and in two of 10 pretreated patients. None of the patients treated during refractory relapse or with disease duration exceeding 2 years responded to thalidomide. Time to response was short, ranging between 0.8 months to 2.8 months. Adverse effects were common but reversible and consisted primarily of constipation, somnolence, fatigue, and mood changes. The daily dose of thalidomide was escalated to 600 mg in only five patients (25%), and in seven patients (35%), this agent was discontinued within 2 months because of intolerance. CONCLUSION: Our data indicate that thalidomide has activity in WM but only low doses were tolerated in this elderly patient population. Confirmatory studies as well as studies that will combine thalidomide with chemotherapy or with rituximab may be relevant.
PURPOSE: We performed a prospective phase II study to assess the activity of thalidomide in patients with Waldenstrom's macroglobulinemia (WM). PATIENTS AND METHODS: Twenty patients with WM were treated with thalidomide at a starting dose of 200 mg daily with dose escalation in 200-mg increments every 14 days as tolerated to a maximum of 600 mg. All patients were symptomatic, their median age was 74 years, and 10 patients were previously untreated. RESULTS: On an intent-to-treat basis, five (25%) of 20 patients achieved a partial response after treatment. Responses occurred in three of 10 previously untreated and in two of 10 pretreated patients. None of the patients treated during refractory relapse or with disease duration exceeding 2 years responded to thalidomide. Time to response was short, ranging between 0.8 months to 2.8 months. Adverse effects were common but reversible and consisted primarily of constipation, somnolence, fatigue, and mood changes. The daily dose of thalidomide was escalated to 600 mg in only five patients (25%), and in seven patients (35%), this agent was discontinued within 2 months because of intolerance. CONCLUSION: Our data indicate that thalidomide has activity in WM but only low doses were tolerated in this elderly patient population. Confirmatory studies as well as studies that will combine thalidomide with chemotherapy or with rituximab may be relevant.
Authors: Sigurdur Y Kristinsson; Ruth M Pfeiffer; Magnus Björkholm; Lynn R Goldin; Sam Schulman; Cecilie Blimark; Ulf-Henrik Mellqvist; Anders Wahlin; Ingemar Turesson; Ola Landgren Journal: Blood Date: 2010-03-18 Impact factor: 22.113
Authors: Meletios A Dimopoulos; Efstathios Kastritis; Roger G Owen; Robert A Kyle; Ola Landgren; Enrica Morra; Xavier Leleu; Ramón García-Sanz; Nikhil Munshi; Kenneth C Anderson; Evangelos Terpos; Irene M Ghobrial; Pierre Morel; David Maloney; Mathias Rummel; Véronique Leblond; Ranjana H Advani; Morie A Gertz; Charalampia Kyriakou; Sheeba K Thomas; Bart Barlogie; Stephanie A Gregory; Eva Kimby; Giampaolo Merlini; Steven P Treon Journal: Blood Date: 2014-07-15 Impact factor: 22.113
Authors: Sigurdur Y Kristinsson; Sandra Eloranta; Paul W Dickman; Therese M-L Andersson; Ingemar Turesson; Ola Landgren; Magnus Björkholm Journal: Am J Hematol Date: 2012-11-19 Impact factor: 10.047
Authors: Steven P Treon; Jacob D Soumerai; Andrew R Branagan; Zachary R Hunter; Christopher J Patterson; Leukothea Ioakimidis; Frederick M Briccetti; Mark Pasmantier; Harvey Zimbler; Robert B Cooper; Maria Moore; John Hill; Alan Rauch; Lawrence Garbo; Luis Chu; Cynthia Chua; Stephen H Nantel; David R Lovett; Hans Boedeker; Henry Sonneborn; John Howard; Paul Musto; Bryan T Ciccarelli; Evdoxia Hatjiharissi; Kenneth C Anderson Journal: Blood Date: 2008-08-19 Impact factor: 22.113