BACKGROUND: Thalidomide has alternative mechanisms of action; it can be combined with dexamethasone or alkylating agents for the treatment of multiple myeloma (MM); however, the optimal doses and appropriate intervals of thalidomide continue to be debated. PATIENTS AND METHODS: We assessed the clinical efficacy and toxicity of thalidomide in patients with newly diagnosed MM; 68 patients were treated with pulsed cyclophosphamide, thalidomide, and dexamethasone (CTD) chemotherapy for induction treatment. RESULTS: After a median of 28 months' follow-up, the overall response rate was 79.4%, with a 42.6% complete response (CR) or very good partial response (VGPR). Patients with cytogenetically high-risk disease had poor CR/VGPR rates (27.3%) at a median of 11.5 months of time to progression (TTP) compared with patients with standard-risk disease who achieved CR/VGPR rates (50%) at a median of 20.3 months of TTP. The major adverse events included peripheral sensory neuropathy (14.3%), infection (10.2%), and thromboembolic complications (5.9%). Thirty-two patients who achieved more than a PR proceeded to peripheral blood stem cell collection with a median number of 5.0 x 106 CD34+ cells/kg collected. CONCLUSION: CTD resulted in a favorable response with tolerable toxicity in patients with MM and did not affect the yield of the stem cell collection.
BACKGROUND:Thalidomide has alternative mechanisms of action; it can be combined with dexamethasone or alkylating agents for the treatment of multiple myeloma (MM); however, the optimal doses and appropriate intervals of thalidomide continue to be debated. PATIENTS AND METHODS: We assessed the clinical efficacy and toxicity of thalidomide in patients with newly diagnosed MM; 68 patients were treated with pulsed cyclophosphamide, thalidomide, and dexamethasone (CTD) chemotherapy for induction treatment. RESULTS: After a median of 28 months' follow-up, the overall response rate was 79.4%, with a 42.6% complete response (CR) or very good partial response (VGPR). Patients with cytogenetically high-risk disease had poor CR/VGPR rates (27.3%) at a median of 11.5 months of time to progression (TTP) compared with patients with standard-risk disease who achieved CR/VGPR rates (50%) at a median of 20.3 months of TTP. The major adverse events included peripheral sensory neuropathy (14.3%), infection (10.2%), and thromboembolic complications (5.9%). Thirty-two patients who achieved more than a PR proceeded to peripheral blood stem cell collection with a median number of 5.0 x 106 CD34+ cells/kg collected. CONCLUSION:CTD resulted in a favorable response with tolerable toxicity in patients with MM and did not affect the yield of the stem cell collection.
Authors: Jae Hoon Lee; Dong Soon Lee; Je Jung Lee; Yoon Hwan Chang; Jong Youl Jin; Deog-Yeon Jo; Soo Mee Bang; Hyo Jung Kim; Jin Seok Kim; Kihyun Kim; Hyeon Seok Eom; Chang Ki Min; Sung Soo Yoon; Sun Hee Kim; Cheolwon Suh; Kyung Sam Cho Journal: Int J Hematol Date: 2010-06-11 Impact factor: 2.490
Authors: Andrzej J Jakubowiak; Kent A Griffith; Donna E Reece; Craig C Hofmeister; Sagar Lonial; Todd M Zimmerman; Erica L Campagnaro; Robert L Schlossman; Jacob P Laubach; Noopur S Raje; Tara Anderson; Melissa A Mietzel; Colleen K Harvey; Sandra M Wear; Jennifer C Barrickman; Craig L Tendler; Dixie-Lee Esseltine; Susan L Kelley; Mark S Kaminski; Kenneth C Anderson; Paul G Richardson Journal: Blood Date: 2011-05-19 Impact factor: 22.113