Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma

Patrizia Tosi, Sonia Ronconi, Elena Zamagni, Claudia Cellini, Santé Tura, Michèle Cavo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Extensive introduction of high-dose therapy with stem cell support has significantly improved the outcome of patients with multiple myeloma (MM) in terms of increased complete remission (CR) rate and extended survival, both disease-free and overall. Few options, however, are presently available for primary refractory patients or patients who relapse after single or double autologous transplantation. Thalidomide, a glutamic acid derivative with anti-angiogenetic properties, has been recently proposed as salvage treatment for such patients. At our Insitution, we have started a therapeutic trial using thalidomide in relapsed/refractory MM patients. From October 1999 to July 2000, 27 patients (17M/1 OF) have been enrolled in the trial, the median age was 60 years, all patients were in stage HI, median b2 microglobulin was 4.36 mg/L, median bone marrow plasma cell infiltration was 70%, 13 patients had been previously submitted to one (n=4) or two (n=9) autologous stem cell transplant, one patient was treated in relapse after allogeneic stem cell transplant. Thalidomide was initially administered at 1 OOmg/day; if well tolerated, the dose was increased serially by 200mg every other week to a maximum of 800mg/day. Median administered dose was 400mg/day. WHO grade > II toxic effects were constipation (40%), lethargy (26%) and skin rash (20%) At present, 20 patients are évaluable for response, 5 (25%) showed more than 50% reduction in serum or urine M protein and 4 (20%) showed a greater than 25% response. After 5 months median follow-up, 4/9 patients are alive and progressionfree, 4 patients have relapsed, 1 patient died of pulmonary oedema while still in partial remission. These data confirm that thalidomide is active in relapsed/refractory MM and could thus deserve further testing, also in combination therapy, eventually as part of frontline treatment programmes.

Original languageEnglish
JournalBlood
Volume96
Issue number11 PART II
Publication statusPublished - 2000

Fingerprint

Salvaging
Salvage Therapy
Thalidomide
Multiple Myeloma
Refractory materials
Stem cells
Transplants
Glutamates
Poisons
Infiltration
Skin
Bone
Stem Cells
Plasmas
Testing
Proteins
Recurrence
Lethargy
Autologous Transplantation
Pulmonary Edema

ASJC Scopus subject areas

  • Hematology

Cite this

Tosi, P., Ronconi, S., Zamagni, E., Cellini, C., Tura, S., & Cavo, M. (2000). Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma. Blood, 96(11 PART II).

Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma. / Tosi, Patrizia; Ronconi, Sonia; Zamagni, Elena; Cellini, Claudia; Tura, Santé; Cavo, Michèle.

In: Blood, Vol. 96, No. 11 PART II, 2000.

Research output: Contribution to journalArticle

Tosi, P, Ronconi, S, Zamagni, E, Cellini, C, Tura, S & Cavo, M 2000, 'Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma', Blood, vol. 96, no. 11 PART II.
Tosi, Patrizia ; Ronconi, Sonia ; Zamagni, Elena ; Cellini, Claudia ; Tura, Santé ; Cavo, Michèle. / Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma. In: Blood. 2000 ; Vol. 96, No. 11 PART II.
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