Long-term outcome in relapsed and refractory multiple myeloma treated with thalidomide. Balancing efficacy and side-effects

Alessandro Corso, Patrizia Zappasodi, Luciana Barbarano, Maria Teresa Petrucci, Antonio Palumbo, Tommaso Caravita, Silvia Mangiacavalli, Anna Maria Cafro, Marzia Varettoni, Francesca Gay, Enrica Morra, Mario Lazzarino

Research output: Contribution to journalArticle

Abstract

A total of 303 MM patients were retrospectively reviewed to evaluate long-term efficacy and toxicity of thalidomide alone or in combination with steroids. Overall response rate was 57% (CR/VGPR 12%). Median TTP, PFS and OS were 13.4 months, 20.6 months, and 26.2 months, respectively. PFS and OS were significantly different according to response (p <0.0001), with better outcome in patients achieving CR/VGPR (PFS and OS 35.4 months and 63 months, respectively). PFS and OS of patients achieving SD or PR were overlapping (p = 0.3). The addition of steroids significantly increased the response rate (p = 0.01). The most clinically relevant complications were neuropathy (40%), constipation (26%), thromboembolic events (7%). Thalidomide was reduced for toxicity in 68 patients (24%) and permanently discontinued in 36 (12%). In conclusion, thalidomide produces high response rate in relapsed/refractory MM. The best outcome is observed in patients with good quality response, but even patients with suboptimal response may obtain durable survival.

Original languageEnglish
JournalLeukemia Research
Volume33
Issue number9
DOIs
Publication statusPublished - Sep 2009

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Keywords

  • Relapsed multiple myeloma
  • Salvage therapy
  • Survival
  • Thalidomide

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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