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 language | English |
|---|---|
| Journal | Blood |
| Volume | 96 |
| Issue number | 11 PART II |
| Publication status | Published - 2000 |
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ASJC Scopus subject areas
- Hematology
Cite this
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 journal › Article
}
TY - JOUR
T1 - Salvage therapy with thalidomide for patients with advanced relapsed/refractory multiple myeloma
AU - Tosi, Patrizia
AU - Ronconi, Sonia
AU - Zamagni, Elena
AU - Cellini, Claudia
AU - Tura, Santé
AU - Cavo, Michèle
PY - 2000
Y1 - 2000
N2 - 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.
AB - 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.
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M3 - Article
AN - SCOPUS:0000359327
VL - 96
JO - Blood
JF - Blood
SN - 0006-4971
IS - 11 PART II
ER -