title: Salvage therapy for multiple myeloma with thalidomide and CED chemotherapy.
abstract: The feasibility and efficacy of a combination of thalidomide, cyclophosphamide, etoposide, and dexamethasone were studied in 56 patients with poor-prognosis multiple myeloma. Of 50 patients evaluable for response, 4% achieved complete response (CR), 64% partial response (PR), 18% minimal response (MR), 6% stable disease (SD), and 8% progressive disease (PD), resulting in an objective response rate (> or = MR) of 86.0% (76.7% overall objective response rate in intent-to-treat analysis; n = 56). Subsequent to successful remission induction, 18 patients received autologous or allogeneic stem cell transplantation. The median progression-free survival in all patients was 16 months. The median overall survival time could not be calculated, since the last observed death occurred after 16 months of follow-up (median follow-up of 14 months) with a corresponding estimated survival probability of 55%. Severe adverse effects (World Health Organization III/IV) included infectious complications (35.7%) and cardiovascular events (7.1%). The data suggest that Thal improves antitumor activity of salvage chemotherapy regimens in poor-prognosis multiple myeloma.
authors.affiliation: University of Heidelberg, Department of Hematology/Oncology/ Rheumatology, Germany. thomas_moehler@med.uni-heidelberg.de
authors.forename: T M
authors.initials: TM
authors.lastname: Moehler
authors.forename: K
authors.initials: K
authors.lastname: Neben
authors.forename: A
authors.initials: A
authors.lastname: Benner
authors.forename: G
authors.initials: G
authors.lastname: Egerer
authors.forename: F
authors.initials: F
authors.lastname: Krasniqi
authors.forename: A D
authors.initials: AD
authors.lastname: Ho
authors.forename: H
authors.initials: H
authors.lastname: Goldschmidt
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D015996:Survival Rate; D013792:Thalidomide / Q000627:therapeutic use*
chemical_list: D013792:Thalidomide; D005047:Etoposide; D003907:Dexamethasone; D003520:Cyclophosphamide