The combination of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with primary amyloidosis (AL)

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Abstract

Based on the efficacy of thalidomide in multiple myeloma and on its synergy with dexamethasone on myeloma plasma cells, we evaluated the combination of thalidomide (100 mg/d, with 100-mg increments every 2 weeks, up to 400 mg) and dexamethasone (20 mg on days 1-4) every 21 days in 31 patients with primary amyloidosis (AL) whose disease was refractory to or had relapsed after first-line therapy. Eleven (35%) patients tolerated the 400 mg/d thalidomide dose. Overall, 15 (48%) patients achieved hematologic response, with 6 (19%) complete remissions and 8 (26%) organ responses. Median time to response was 3.6 months (range, 2.5-8.0 months). Treatment-related toxicity was frequent (65%), and symptomatic bradycardia was a common (26%) adverse reaction. The combination of thalidomide and dexamethasone is rapidly effective and may represent a valuable second-line treatment for AL.

Original languageEnglish
Pages (from-to)2949-2951
Number of pages3
JournalBlood
Volume105
Issue number7
DOIs
Publication statusPublished - Apr 1 2005

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Thalidomide
Poisons
Dexamethasone
Multiple Myeloma
Amyloidosis
Therapeutics
Bradycardia
Refractory materials
Toxicity
Plasmas
Primary amyloidosis

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "The combination of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with primary amyloidosis (AL)",
abstract = "Based on the efficacy of thalidomide in multiple myeloma and on its synergy with dexamethasone on myeloma plasma cells, we evaluated the combination of thalidomide (100 mg/d, with 100-mg increments every 2 weeks, up to 400 mg) and dexamethasone (20 mg on days 1-4) every 21 days in 31 patients with primary amyloidosis (AL) whose disease was refractory to or had relapsed after first-line therapy. Eleven (35{\%}) patients tolerated the 400 mg/d thalidomide dose. Overall, 15 (48{\%}) patients achieved hematologic response, with 6 (19{\%}) complete remissions and 8 (26{\%}) organ responses. Median time to response was 3.6 months (range, 2.5-8.0 months). Treatment-related toxicity was frequent (65{\%}), and symptomatic bradycardia was a common (26{\%}) adverse reaction. The combination of thalidomide and dexamethasone is rapidly effective and may represent a valuable second-line treatment for AL.",
author = "Giovanni Palladini and Vittorio Perfetti and Stefano Perlini and Laura Obici and Francesca Lavatelli and Riccardo Caccialanza and Rosangela Invernizzi and Benedetto Comotti and Giampaolo Merlini",
year = "2005",
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doi = "10.1182/blood-2004-08-3231",
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publisher = "American Society of Hematology",
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T1 - The combination of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with primary amyloidosis (AL)

AU - Palladini, Giovanni

AU - Perfetti, Vittorio

AU - Perlini, Stefano

AU - Obici, Laura

AU - Lavatelli, Francesca

AU - Caccialanza, Riccardo

AU - Invernizzi, Rosangela

AU - Comotti, Benedetto

AU - Merlini, Giampaolo

PY - 2005/4/1

Y1 - 2005/4/1

N2 - Based on the efficacy of thalidomide in multiple myeloma and on its synergy with dexamethasone on myeloma plasma cells, we evaluated the combination of thalidomide (100 mg/d, with 100-mg increments every 2 weeks, up to 400 mg) and dexamethasone (20 mg on days 1-4) every 21 days in 31 patients with primary amyloidosis (AL) whose disease was refractory to or had relapsed after first-line therapy. Eleven (35%) patients tolerated the 400 mg/d thalidomide dose. Overall, 15 (48%) patients achieved hematologic response, with 6 (19%) complete remissions and 8 (26%) organ responses. Median time to response was 3.6 months (range, 2.5-8.0 months). Treatment-related toxicity was frequent (65%), and symptomatic bradycardia was a common (26%) adverse reaction. The combination of thalidomide and dexamethasone is rapidly effective and may represent a valuable second-line treatment for AL.

AB - Based on the efficacy of thalidomide in multiple myeloma and on its synergy with dexamethasone on myeloma plasma cells, we evaluated the combination of thalidomide (100 mg/d, with 100-mg increments every 2 weeks, up to 400 mg) and dexamethasone (20 mg on days 1-4) every 21 days in 31 patients with primary amyloidosis (AL) whose disease was refractory to or had relapsed after first-line therapy. Eleven (35%) patients tolerated the 400 mg/d thalidomide dose. Overall, 15 (48%) patients achieved hematologic response, with 6 (19%) complete remissions and 8 (26%) organ responses. Median time to response was 3.6 months (range, 2.5-8.0 months). Treatment-related toxicity was frequent (65%), and symptomatic bradycardia was a common (26%) adverse reaction. The combination of thalidomide and dexamethasone is rapidly effective and may represent a valuable second-line treatment for AL.

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U2 - 10.1182/blood-2004-08-3231

DO - 10.1182/blood-2004-08-3231

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JO - Blood

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