Can thalidomide be effective to treat plasma cell leptomeningeal infiltration?

Central nervous system multiple myeloma: a different cytogenetic profile?

“…The role of novel agents and the newer biologically active drugs is unknown. Previous studies demonstrated that thalidomide penetrated through the blood‐brain barrier (BBB) and had a transient effect (Chen et al , ), but others showed no benefit of thalidomide in CNS MM (Vicari et al , ). The data from some studies had indicated that bortezomib did not penetrate into the CNS (Patriarca et al , ).…”

Effective treatment of leptomeningeal multiple myeloma with total craniospinal irradiation supported by second allogeneic donor stem cell infusion

“…The small number of cases reported generally occurred in the setting of pre-existing stage III MM 2-4 associated with an elevated LDH level, 5,6 unfavourable cytogenetic abnormalities 6 and plasma cell leukemia. 4,6 Not surprisingly, the prognosis is extremely poor. Based on previously reported cases and accepting the bias for reporting only responding patients, Peterson et al 7 estimated the median overall survival to be only 1.5 months from the time of diagnosis of meningeal involvement.…”

“…[2][3][4][5][6][7][8] Often, transient neurological improvement is seen, but progression and death inevitably follow shortly after.…”

Zajęcie ośrodkowego układu nerwowego w przebiegu szpiczaka plazmocytowego – opis przypadku i przegląd literatury

“…Po doustnym zażyciu talidomidu już przy dawce 100 mg/d można stwierdzić obecność leku w płynie mózgowo-rdzeniowym [22]. Na efekt działania talidomidu trzeba jednak czekać kilka do kilkunastu tygodni, co może tłumaczyć stosunkowo słabą skuteczność leku w sytuacji o zwykle agresywnym i szybkim przebiegu [23]. Wykazano, choć nie w badaniach z udziałem ludzi, że lenalidomid również penetruje do OUN [24].…”