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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 3.8×106/kg.
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Fig. 1
Overall survival (OS) and progression-free survival (PFS) of 56 multiple myeloma patients treated with thalidomide-containing regimens as a primary therapy.
Fig. 2
OS (A) and PFS (B) of 56 multiple myeloma patients, according to thalidomide-containing regimens as a primary therapy (OS: P=0.82; PFS: P=0.27).
Fig. 3
OS (A) and PFS (B) of 56 multiple myeloma patients, according to the undergoing autologous transplantation (OS: P=0.27; PFS: P=0.18).
Table 1.
Characteristics of patients
Table 2.
Response after thalidomide-containing combination chemotherapy
Table 3.
Adverse events regimens by more than g following thalido grade III omide-containing
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