Korean J Hematol.  2006 Jun;41(2):83-91. 10.5045/kjh.2006.41.2.83.

Clinical Efficacy of Thalidomide Containing Regimens as a Primary Therapy in Patients with Multiple Myeloma

• Jeong SH
• Lee JJ
• Sohn SK
• Shin HJ
• Yang DH
• Kim YK
• Kim SK
• Baek JH
• Kim DH
• Kim JG
• Chung JS
• Cho GJ
• Kim HJ

• KMID: 2083481
• DOI: http://doi.org/10.5045/kjh.2006.41.2.83

Abstract

BACKGROUND: The aim of this study was to assess the efficacy and toxicity of thalidomide-containing regimens as the first-line therapy for patients with multiple myeloma.
METHODS
A total of 60 patients were initially treated with thalidomide-containing regimens at three institutions. Thalidomide was given with two different regimens: the TD regimen (thalidomide and dexamethasone) and the TCD regimen (thalidomide, cyclophosphamide, and dexamethasone). Autologous peripheral blood stem cells (PBSC) were collected after mobilizing with G-CSF with or without cyclophosphamide.
RESULTS
Of all the patients, 56 patients (TD regimen: 12 patients, TCD regimen: 44 patients) who received at least 4 cycles or more were evaluated for response and toxicity. The median age of the patients was 65.5 years (age range: 39~80 years). The overall response rate for the thalidomide-containing regimens was 85.5%. There were 3 (25%) complete responses and 6 (50%) partial responses for the TD regimen and there were 17 (38.6%) complete responses and 21 (47.7%) partial responses for the TCD regimen, respectively. The toxicity, according to the NCI-CTC (grade 3/4) included neutropenia in 7 patients (12.5%), thrombocytopenia in 4 patients (7.1%), infection in 6 patients (10.7%) and neuropathy in 10 patients (17.8%). In addition, there were 2 patients (3.6%) with thrombosis. Thirteen patients, who achieved more than a partial response to the thalidomide-containing regimen, proceeded to PBSC collection and the median number of CD34+ cells collected was 3.8 x 106/kg.
CONCLUSION
Thalidomide-based combination chemotherapy is a safe, well tolerated and effective regimen for patients with newly diagnosed multiple myeloma, and it showed a high response rates, relatively low toxicity and sufficient collection of PBSCs.

Keyword

Thalidomide; Multiple myeloma; Primary therapy

MeSH Terms

Cyclophosphamide
Drug Therapy, Combination
Granulocyte Colony-Stimulating Factor
Humans
Multiple Myeloma*
Neutropenia
Stem Cells
Thalidomide*
Thrombocytopenia
Thrombosis
Cyclophosphamide
Granulocyte Colony-Stimulating Factor
Thalidomide

Figure

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  Fig. 1 Overall survival (OS) and progression-free survival (PFS) of 56 multiple myeloma patients treated with thalidomide-containing regimens as a primary therapy.

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  Fig. 2 OS (A) and PFS (B) of 56 multiple myeloma patients, according to thalidomide-containing regimens as a primary therapy (OS: P=0.82; PFS: P=0.27).

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  Fig. 3 OS (A) and PFS (B) of 56 multiple myeloma patients, according to the undergoing autologous transplantation (OS: P=0.27; PFS: P=0.18).

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