Pulsed cyclophosphamide, thalidomide and dexamethasone regimen for previously treated patients with multiple myeloma: Long term follow up and disease control after subsequent treatments

Ρούσσου, Μαρία; Anagnostopoulos, Athanasios; Kastritis, Efstathios; Matsouka, Charis; Barmparousi, Despina; Koutsoukou, Vasiliki

doi:10.1080/10428190601186168

Cited by 15 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In refractory or relapsed myeloma, combinations including thalidomide or bortezomib with dexamethasone and cyclophosphamide have been extensively investigated [14][15][16][17][18]. The regimen containing cyclophosphamide, thalidomide, and dexamethasone was well tolerated and effective in patients with relapsed MM, achieving ORR of 83-90% [16,17].…”

Section: Discussionmentioning

confidence: 99%

Salvage treatment with upfront melphalan 100 mg/m2 and consolidation with novel drugs for fulminant progression of multiple myeloma

et al. 2009

View full text Add to dashboard Cite

Patients (pts) with fulminant progression (FPG) of multiple myeloma (MM) after autologous stem cell transplantation (ASCT) have poor prognosis. Pancytopenia, extramedullary disease, and/or renal impairment are often present, and treatment options are limited. We have retrospectively evaluated 31 pts with FPG of MM after ASCT who were treated upfront salvage therapy with melphalan 100 mg/m 2 (MEL 100) followed by PBSC support and consolidation therapy using regimens containing thalidomide (n=16) or bortezomib (n=15). The overall response rate (ORR) was 58% (18/31). After MEL 100, one patient achieved complete remission (3%), 26% of pts very good partial remission, 29% of pts partial remission, and 42% of pts stable disease. Progression within 3 months after MEL 100 occurred in 35% of pts. The median follow-up from MEL 100 was 8 months. The median TTP was 5 months (range, 2-15 months), and the median OS was 8 months (range, 3-23 months). There were no treatment-related deaths. In fulminant progression of MM, upfront MEL 100 is a safe salvage regimen with good response rate (ORR, 58%). Treatment with upfront MEL 100 followed by a thalidomide-or bortezomibbased regimen can prolong overall survival to more than 12 months in 33% of pts with fulminant progression of MM.

show abstract

Section: Discussionmentioning

confidence: 99%

Salvage treatment with upfront melphalan 100 mg/m2 and consolidation with novel drugs for fulminant progression of multiple myeloma

et al. 2009

View full text Add to dashboard Cite

show abstract

“…The ideal induction treatment should be effective in reducing tumor burden, while having minimal negative effects on stem cell mobilization. A combination of thalidomide, cyclophosphamide and dexamethasone (TCD) has been widely used in the upfront or salvage setting for treating patients both eligible and ineligible for ASCT [4,5,6,7,8]. The antimyeloma effect of these drugs is mainly based on their activity as immune modulators.…”

Section: Introductionmentioning

confidence: 99%

Thalidomide, Cyclophosphamide and Dexamethasone Induction Therapy: Feasibility for Myeloma Patients Destined for Autologous Stem Cell Transplantation

Chang¹,

Kang

Lee

et al. 2014

Acta Haematol

View full text Add to dashboard Cite

This study explored the effect of thalidomide and cyclophosphamide on stem cell collection, in addition to assessing their efficacy as induction therapy for myeloma patients destined for autologous stem cell transplantation (ASCT). We analyzed newly diagnosed myeloma patients who received TCD (thalidomide 100 mg/day for 28 days, oral cyclophosphamide 150 mg/m²/day and dexamethasone 40 mg/day on days 1-4) as induction therapy prior to ASCT. Peripheral stem cells were mobilized with granulocyte colony-stimulating factor and cyclophosphamide. Thirty-six patients (median age 54 years) received TCD chemotherapy (median 4 cycles). The overall response rate to TCD was 77.8% (28/36). The median number of CD34+ cells was 6.5 × 10⁶/kg, and 2 patients failed to achieve the optimal number of CD34+ cells, i.e. 4.0 × 10⁶/kg, although they were able to attain >2.0 × 10⁶/kg. The overall response rate increased up to 94.4% (34/36) after ASCT; this included 9 patients with a stringent complete response without transplantation-related mortality. Four patients died due to disease progression and 17 were found to have progressed after ASCT (the median progression-free survival after ASCT was 19.6 months). TCD chemotherapy can be an effective and feasible induction regimen prior to ASCT for myeloma patients.

show abstract

“…Recently, the combined regimen of thalidomide, an alkylating agent, and a steroid is widely used; it is an active regimen with a higher response rate than thalidomide or alkylating agent monotherapy approaches. The response rate of this combination treatment exceeded 80% in newly diagnosed cases of myeloma , and 60–70% in relapsed or refractory cases .…”

Section: Introductionmentioning

confidence: 91%

Efficacy and toxicity of the combination chemotherapy of thalidomide, alkylating agent, and steroid for relapsed/refractory myeloma patients: a report from the Korean Multiple Myeloma Working Party (KMMWP) retrospective study

et al. 2016

View full text Add to dashboard Cite

We analyzed the treatment responses, toxicities, and survival outcomes of patients with relapsed or refractory multiple myeloma who received daily thalidomide, cyclophosphamide, and dexamethasone (CTD) or daily thalidomide, melphalan, and prednisolone (MTP) at 17 medical centers in Korea. Three‐hundred and seventy‐six patients were enrolled. The combined chemotherapy of thalidomide, corticosteroid, and an alkylating agent (TAS) was second‐line chemotherapy in 142 (37.8%) patients, and third‐line chemotherapy in 135 (35.9%) patients. The response rate overall was 69.4%. Patients who were not treated with bortezomib and lenalidomide before TAS showed a higher response rate compared to those who were exposed to these agents. The estimated median progression‐free survival and overall survival times were 10.4 months and 28.0 months, respectively. The adverse events during TAS were generally tolerable, but 39 (10.4%) patients experienced severe infectious complications. There were no differences in terms of efficacy between CTD and MTP, but infectious complications were more common in CTD group. TAS is an effective treatment regimen which induces a high response rate in relapsed or refractory multiple myeloma patients. Due to the high incidence of grade 3 or 4 infection, proper management of infection is necessary during the TAS treatment, especially the CTD.

show abstract

Pulsed cyclophosphamide, thalidomide and dexamethasone regimen for previously treated patients with multiple myeloma: Long term follow up and disease control after subsequent treatments

Cited by 15 publications

References 10 publications

Salvage treatment with upfront melphalan 100 mg/m2 and consolidation with novel drugs for fulminant progression of multiple myeloma

Salvage treatment with upfront melphalan 100 mg/m2 and consolidation with novel drugs for fulminant progression of multiple myeloma

Thalidomide, Cyclophosphamide and Dexamethasone Induction Therapy: Feasibility for Myeloma Patients Destined for Autologous Stem Cell Transplantation

Efficacy and toxicity of the combination chemotherapy of thalidomide, alkylating agent, and steroid for relapsed/refractory myeloma patients: a report from the Korean Multiple Myeloma Working Party (KMMWP) retrospective study

Contact Info

Product

Resources

About