Attainment of a stringent complete response in multiple myeloma with thalidomide monotherapy.

Treatment of patients with multiple myeloma (MM) has drastically changed with the introduction of novel agents such as thalidomide, lenalidomide, and bortezomib, but treatment outcome of elderly patients has remained dismal mainly due to toxicities. We report an 82-year-old MM patient attaining stringent complete response (sCR) at 12 months with a daily dose of 100 mg of thalidomide monotherapy. She remains on thalidomide monotherapy and presently maintains a normalized serum free light chain ratio at 18 months. This is the first case of MM achieving sCR with thalidomide monotherapy, and shows that single-agent thalidomide can be effective and concomitant use of dexamethasone may not be necessary in frail elderly patients.