Clinical Efficacy of Thalidomide Containing Regimens as a Primary Therapy in Patients with Multiple Myeloma / 대한혈액학회지

ABSTRACT

BACKGROUND: The aim of this study was to assess the efficacy and toxicity of thalidomide-containing regimens as the first-line therapy for patients with multiple myeloma. METHODS: A total of 60 patients were initially treated with thalidomide-containing regimens at three institutions. Thalidomide was given with two different regimens the TD regimen (thalidomide and dexamethasone) and the TCD regimen (thalidomide, cyclophosphamide, and dexamethasone). Autologous peripheral blood stem cells (PBSC) were collected after mobilizing with G-CSF with or without cyclophosphamide. RESULTS: Of all the patients, 56 patients (TD regimen 12 patients, TCD regimen 44 patients) who received at least 4 cycles or more were evaluated for response and toxicity. The median age of the patients was 65.5 years (age range 39~80 years). The overall response rate for the thalidomide-containing regimens was 85.5%. There were 3 (25%) complete responses and 6 (50%) partial responses for the TD regimen and there were 17 (38.6%) complete responses and 21 (47.7%) partial responses for the TCD regimen, respectively. The toxicity, according to the NCI-CTC (grade 3/4) included neutropenia in 7 patients (12.5%), thrombocytopenia in 4 patients (7.1%), infection in 6 patients (10.7%) and neuropathy in 10 patients (17.8%). In addition, there were 2 patients (3.6%) with thrombosis. Thirteen patients, who achieved more than a partial response to the thalidomide-containing regimen, proceeded to PBSC collection and the median number of CD34+ cells collected was 3.8 x 106/kg. CONCLUSION: Thalidomide-based combination chemotherapy is a safe, well tolerated and effective regimen for patients with newly diagnosed multiple myeloma, and it showed a high response rates, relatively low toxicity and sufficient collection of PBSCs.