Low dose thalidomide as maintenance in multiple myeloma

ABSTRACT

Autologous hematopoietic stem cell transplantation [ASCT] following chemotherapy improves survival and decrease relapse rate in patients with multiple myeloma. However, patients not eligible for ASCT relapse earlier demanding search for new treatment modalities. was to evaluate the effect of low dose thalidomide as maintenance therapy in patients attaining a complete remission after chemotherapy and who not candidates for autologous stem cell transplantation. This study was carried out on a total of 92 patients randomized in two groups, group I [arm A] [44 patients] received 50 mg thalidomide daily and group II [arm B] [48 patients] did not receive any maintenance treatment the follow up period was 40 months. Median age for group I was 66 years and 68 years for group II Male to female ratio was 31 for both groups. Regarding the types of myeloma; IgG kappa myloma represented 70% of cases in group I and 75% of group II, IgG lambda constituted 20% and 19% in group I and II respectively. Out of the 44 patients in group I, only 12 patients relapsed during the follow up period, 9 of them died, while 40 patients relapsed from group II of which 26 died thus showing a significant difference between both groups [P<0.01]. The maintenance with low dose thalidomide following initial chemotherapy may show beneficial results in terms of prevention of relapse and overall survival in comparison to the non-maintenance arm