Long‐term results of thalidomide in refractory and relapsed multiple myeloma with emphasis on response duration

Cibeira, MT; Rosiñol, Laura; Ramiro, Laia; Esteve, Jordi; Torrebadell, Montserrat; Bladé, Joan

doi:10.1111/j.0902-4441.2006.t01-1-ejh2783.x

Cited by 29 publications

(10 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 2-year event-free (EFS) and overall survival (OS) were 20% and 48%, respectively. [9][10][11] A systematic review of phase 2 trials identified 42 trials investigating 1674 patients. The PR rate was 29.4%.…”

Section: Clinical Experiences Single-agent Thalidomidementioning

confidence: 99%

Thalidomide for treatment of multiple myeloma: 10 years later

Palumbo

Façon

Sonneveld

et al. 2008

Blood

287

189

View full text Add to dashboard Cite

Thalidomide, bortezomib, and lenalidomide have recently changed the treatment paradigm of myeloma. In young, newly diagnosed patients, the combination of thalidomide and dexamethasone has been widely used as induction treatment before autologous stem cell transplantation (ASCT). In 2 randomized studies, consolidation or maintenance with low-dose thalidomide has extended both progression-free and overall survival in patients who underwent ASCT at diagnosis. In elderly, newly diagnosed patients, 3 independent randomized studies have reported that the oral combination of melphalan and prednisone plus thalidomide (MPT) is better than the standard melphalan and prednisone (MP). These studies have shown better progression-free survival, and 2 have shown improved overall survival for patients assigned to MPT. In refractory-relapsed disease, combinations including thalidomide with dexamethasone, melphalan, doxorubicin, or cyclophosphamide have been extensively investigated. The risks of side effects are greater when thalidomide is used in combination with other drugs. Thromboembolism and peripheral neuropathy are the major concern. The introduction of anticoagulant prophylaxis has reduced the rate of thromboembolism to less than 10%. Immediate thalidomide dose reduction or discontinuation when paresthesia is complicated by pain or motor deficit has decreased the severity of neuropathy. Future studies will define the most effective or the best sequence of combinations which could improve life expectancy. (Blood. 2008;111:3968-3977)

show abstract

Section: Clinical Experiences Single-agent Thalidomidementioning

confidence: 99%

Thalidomide for treatment of multiple myeloma: 10 years later

Palumbo

Façon

Sonneveld

et al. 2008

Blood

287

189

View full text Add to dashboard Cite

show abstract

“…Based on observation that in PCL the response to standard therapy is extremely poor and the use of thalidomide in advanced MM has resulted in marked responses even in patients with advanced diseases, including those who relapsed after high-dose chemotherapy [69][70][71][72], some authors have used this promising drug also in patients with PCL [73,74]. Wohrer et al [75] reported the use of thalidomide in a patient with PPCL as a first line therapy achieving a very good partial response rapidly.…”

Section: Thalidomidementioning

confidence: 99%

Plasma cell leukemia: a highly aggressive monoclonal gammopathy with a very poor prognosis

Jiménez-Zepeda

Dominguez-Martinez

2009

Int J Hematol

View full text Add to dashboard Cite

Plasma cell leukemia (PCL) is an aggressive variant of multiple myeloma and is characterized by the presence of >20% and/or an absolute number of greater 2 x 10(9)/L plasma cells circulating in the peripheral blood. PCL represents approximately 2-4% of all MM diagnosis and exists in two forms: primary PCL (PPCL, 60% of cases) presents de novo, whereas secondary PCL (SPCL, accounts for the remaining 40%) consists of a leukemic transformation in patients with a previously diagnosed MM. Because the mechanisms contributing to the pathogenesis of PCL are not fully understood, immunophenotyping, genetic evaluation (conventional karyotype, FISH, GEP and array-CGH), and immunohistochemistry are really important tools to investigate why plasma cells escape from bone marrow and become highly aggressive. Since treatment with standard agents and steroids is poorly effective, a combination of new drugs as part of the induction regimens and bone marrow transplant (autologous and allogeneic approaches) could nearly overcome the poor prognosis exhibited by PCL patients.

show abstract

“…Anagnostopoulos et al [19] reported the median OS of 38 months. Cibeira et al [20] reported PFS of 15.6 months and OS of 28.4 months among relapsing MM patients.…”

Section: Discussionmentioning

confidence: 99%

Thalidomide, dexamethasone and lovastatin with autologous stem cell transplantation as a salvage immunomodulatory therapy in patients with relapsed and refractory multiple myeloma

et al. 2011

View full text Add to dashboard Cite

The treatment of patients with multiple myeloma usually includes many drugs including thalidomide, lenalidomide and bortezomib. Lovastatin and other inhibitors of HMG-CoA reductase demonstrated to exhibit antineoplasmatic and proapoptotic properties in numerous in vitro studies involving myeloma cell lines. We treated 91 patients with relapsed or refractory multiple myeloma with thalidomide, dexamethasone and lovastatin (TDL group, 49 patients) or thalidomide and dexamethasone (TD group, 42 patients). A clinical response defined of at least 50% reduction of monoclonal band has been observed in 32% of TD patients and 44% of TDL patients. Prolongation of overall survival and progression-free survival in the TDL group as compared with the TD group has been documented. The TDL regimen was safe and well tolerated. The incidence of side effects was comparable in both groups. Plasma cells have been cultured in vitro with thalidomide and lovastatin to assess the impact of both drugs on the apoptosis rate of plasma cells. In vitro experiments revealed that the combination of thalidomide and lovastatin induced higher apoptosis rate than apoptosis induced by each drug alone. Our results suggest that the addition of lovastatin to the TD regimen may improve the response rate in patients with relapsed or refractory myeloma.

show abstract

Long‐term results of thalidomide in refractory and relapsed multiple myeloma with emphasis on response duration

Abstract: These results show that the effect of thalidomide in refractory/relapsed MM can be sustained, particularly in patients who achieve a greater degree of response, and support the finding that this drug can be used for maintenance therapy.

Cited by 29 publications

References 53 publications

Thalidomide for treatment of multiple myeloma: 10 years later

Thalidomide for treatment of multiple myeloma: 10 years later

Plasma cell leukemia: a highly aggressive monoclonal gammopathy with a very poor prognosis

Thalidomide, dexamethasone and lovastatin with autologous stem cell transplantation as a salvage immunomodulatory therapy in patients with relapsed and refractory multiple myeloma

Contact Info

Product

Resources

About