ABSTRACT
OBJECTIVE: To study the efficacy of thalidomide for treating acute leukemia (AL). METHODS: 38 cases of AL were studied. 27 of the 38 cases receiving initial treatment were randomly divided into two groups, one treated with routine chemotherapy plus thalidomide (A) and the other with routine chemotherapy alone (B). 11 of the 38 were relapsing cases and all treated with routine chemotherapy plus thalidomide (C). Marrow microvascular density (MVD) and vascular endothelial growth factor (VEGF) were examined with factor-VIII related antigen/CD(34) immunohistological stain and ELISA respectively before and after the treatment. The initial dose of thalidomide was 200 mg/d and increased to 400 - 500 mg/d by increasing 50 mg/d weekly for 4 to 6 months. RESULTS: The complete remission (CR) rate and efficacy rate were 57.1%, 53.8% and 78.6%, 76.9% in the two groups respectively with no statistical difference. The CR rate and efficacy rate in the relapsing group were 27.3%, 54.5%. The relapsing rate 6 months after the treatment was low in the thalidomide group. MVD and VEGF were significantly different before and after the treatment (P < 0.001). There was a negative correlation between the MVD, VEGF and efficacy. The relapsing rate was low in cases with low MVD, VEGF. No particular side effects were observed in thalidomide group. CONCLUSION: Anti-angiogenesis may decrease relapse and maintain recovery state of AL patients. There are no severe side effects in the thalidomide group.
