A Combination of Melphalan, Prednisone, and 50 mg Thalidomide Treatment in Non-Transplant-Candidate Patients with Newly Diagnosed Multiple Myeloma
The Korean Journal of Internal Medicine
;
: 403-409, 2011.
Article
in English
| WPRIM
| ID: wpr-46543
ABSTRACT
BACKGROUND/AIMS:
The clinical efficacy and safety of a three-drug combination of melphalan, prednisone, and thalidomide were assessed in patients with multiple myeloma who were not candidates for high-dose therapy as a first-line treatment. Because the side effects of thalidomide at a dose of > or = 100 mg daily can be a barrier to effective treatment for these patients, we evaluated the efficacy and safety of a reduced dose of thalidomide, 50 mg, for non-transplant candidates.METHODS:
Twenty-one patients were treated in 4-week cycles, receiving 4 mg/m2 melphalan and 40 mg/m2 prednisone on days 1-7 and 50 mg thalidomide daily. The primary efficacy outcome was the overall response rate. Aspirin (100 mg daily) was also provided as prophylactic treatment for thromboembolism.RESULTS:
The overall response rate was 57.1%; a complete response was seen in 23.8% of patients, a partial response in 33.3%, and stable disease in 9.5%. After a median follow-up time of 16.1 months, the median time to progression was 11.4 months (95% confidence interval, 2.1 to 20.6); the median overall survival was not reached. Grades 3 and 4 adverse events included infection (10%), peripheral neuropathy (5%), diarrhea (5%), thrombosis (10%), and loss of consciousness (10%). Two patients discontinued treatment due to loss of consciousness and neuropathy.CONCLUSIONS:
Low-dose thalidomide (50 mg) plus melphalan and prednisone is an effective combination drug therapy option for newly diagnosed myeloma patients who are ineligible for high-dose chemotherapy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Thalidomide
/
Time Factors
/
Prednisone
/
Confidence Intervals
/
Risk
/
Treatment Outcome
/
Disease Progression
/
Antineoplastic Agents, Hormonal
/
Antineoplastic Agents, Alkylating
/
Angiogenesis Inhibitors
Type of study:
Diagnostic study
/
Etiology study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2011
Type:
Article
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