Thalidomide in patients with advanced multiple myeloma: a study of 83 patients–report of the intergroupe francophone du myélome (IFM)

Yakoub-Agha, Ibrahim; Attal, Michel; Dumontet, Charles; Delannoy,; Moreau, Philippe; Berthou, Christian; Lamy, Tina; Grosbois, B.; Dauriac, Charles; Dorvaux,; Jo, Bay; Monconduit, M; Duguet, C.; Duhamel, Alain; Facon, Thierry

doi:10.1038/sj.thj.6200175

Cited by 78 publications

(62 citation statements)

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“…Since PCLI and cytogenetics are usually not available in the standard practice setting outside of specialised centres, b2M and CRP have an independent prognostic importance for survival. The results of our study confirm the results obtained by Singhal et al (1999) and Yakoub-Agha et al (2002) that the albumin serum level is a useful parameter, determining the response to THAL treatment.…”

Section: Discussionsupporting

confidence: 91%

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

et al. 2004

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The aim of this study was to assess the prognostic value of pretreatment clinical and laboratory parameters in refractory or relapsed multiple myeloma (MM) patients who have a long-term response to thalidomide (THAL), lasting at least 18 months. The study was carried out on 234 patients who received THAL for relapsed/refractory myeloma. Out of the 234 patients, 129 patients (55.1%) responded to THAL with a mean response duration of 11.9 months (ranging from 1 to 48) and an overall survival rate of 20.3 months (ranging 1 -55 months). In 64 patients (27.4% of the whole group), the response to THAL lasted X18 months with a mean response lasting 24 months. Statistical analysis of the group of nonresponders and patients with long-term response to THAL showed a significantly higher serum albumin level (P ¼ 0.0003) and haemoglobin level (P ¼ 0.05), as well as a lower b2 microglobulin (b2M) (P ¼ 0.022), LDH (P ¼ 0.045) serum level in patients with long-term response. In this study, the LDH and serum albumin level were predictors for response to THAL therapy. The b2M serum level was not a predictor for response to THAL. The albumin serum level was the best parameter distinguishing the group of patients with long-term response to THAL from the entire responding group (P ¼ 0.02).

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Section: Discussionsupporting

confidence: 91%

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

et al. 2004

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“…19 Response rates of about 30% reported by Singhal et al 8 were confirmed by others groups. 9,[20][21][22][23] Addition of dexamethasone to thalidomide in patients who failed to benefit from prior therapy, including both thalidomide and dexamethasone given as single agents, further increased responses, up to an overall response rate of 50-55%. 10,11 These data suggested a synergy between thalidomide and dexamethasone and prompted several groups to explore this combination also in patients with previously untreated MM.…”

Section: Discussionmentioning

confidence: 99%

“…Number of days to ANC4500/ml 11 (9-16) PLTC420 000/ml 14 (10-22) PLTC450 000/ml 17 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) PLT transfusions (no.) 3 (0-16) RBC transfusions (no.)…”

Section: Discussionmentioning

confidence: 99%

First-line thalidomide–dexamethasone therapy in preparation for autologous stem cell transplantation in young patients (<61 years) with symptomatic multiple myeloma

Abdelkefi¹,

Torjman²,

Romdhane

et al. 2005

Bone Marrow Transplant

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Summary:Thalidomide-dexamethasone therapy was given in patients (o61 years) with previously untreated symptomatic multiple myeloma. The aim of this study was to assess the efficacy and toxicity of this combination as first-line therapy, and to determine its effect on stem cell collection and engraftment. During first-line therapy, thalidomide and dexamethasone were administered for 75 days (200 mg/day) and 3 months, respectively. The monthly dose of dexamethasone was 20 mg/m 2 /day for 4 days, with cycles repeated on days 9 to 12 and 17 to 20 on the first and the third month of therapy. After first-line therapy, a collection of peripheral blood stem cells (PBSC) was performed. Between May 2003 and September 2004, 60 patients were included. On an intent-to-treat basis, the overall response (Xpartial response) rate was 74%, including 24% of patients who obtained a complete remission. Grade 3-4 toxicities consisted of infections (12%), deep-vein thrombosis (3%), constipation (5%), and neuropathy (5%). A total of 58 patients (96%) proceeded to PBSC mobilisation and yielded a median number of 8 Â 10 6 CD34 þ cells/kg. First-line thalidomide-dexamethasone therapy is effective and relatively well tolerated in young patients with symptomatic multiple myeloma. This combination does not affect PBSC mobilisation.

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“…Thalidomide monotherapy has recently been shown to be active in relapsed or refractory multiple myeloma with response rates (> 25% serum paraprotein reduction) ranging between 32% and 66% Juliusson et al, 2000;Rajkumar et al, 2000;Hus et al, 2001;Yakoub-Agha et al, 2002). Responses were more frequent in patients with a low plasma cell labelling index and normal cytogenetics , whereas a dose-response effect was demonstrated, especially for highrisk patients (Barlogie et al, 2000).…”

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confidence: 99%

Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

et al. 2003

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Summary. Sixty patients with advanced multiple myeloma received 2-6 monthly treatment courses combining hyperfractionated cyclophosphamide (300 mg/m 2 i.v. over 3 h q 12 h · 6, d 1-3) with pulsed dexamethasone (20 mg/m 2 /d p.o., d 1-4, 9-12, 17-20) and once daily thalidomide at individually escalating doses (100-400 mg/d) depending on tolerability (HyperCDT). Responding patients were maintained on daily thalidomide and monthly dexamethasone pulses. Complete, partial and minor response rates were 4%, 68% and 12% respectively; overall response rate was 84% (efficacy analysis). Median event-free and overall survival was 11 and 19 months respectively. During at least one treatment cycle, 67% of patients experienced grade 4 neutropenia resulting in 17% grade 3 and 9% grade 4 infections. Side-effects, presumably related to thalidomide, included neuropathy (40% grade 2, 16% grade 3), constipation (17%), oedema (5%), bradycardia (5%), skin reactions (3%), cerebrovascular events (5%) and deep vein thromboses (8%). Thromboses were not related to known thrombophilic risk factors. Four patients with prior myeloma therapy > 50 months developed myelodysplastic syndrome or secondary acute myeloid leukaemia 2-4 months after study entry. HyperCDT is a highly active and reasonably well-tolerated salvage regimen in advanced or refractory multiple myeloma.

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Thalidomide in patients with advanced multiple myeloma: a study of 83 patients–report of the intergroupe francophone du myélome (IFM)

Cited by 78 publications

References 0 publications

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

First-line thalidomide–dexamethasone therapy in preparation for autologous stem cell transplantation in young patients (<61 years) with symptomatic multiple myeloma

Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

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