title: Thalidomide in low doses is effective for the treatment of resistant or relapsed multiple myeloma and for plasma cell leukaemia.
abstract: Thalidomide is an effective treatment for relapsed multiple myeloma (MM), but is associated with a significant side effect profile at higher doses. In a recent study, only half of the enrolled patients were able to tolerate the maximum dose of 800 mg/day [Singhal, S., et al. (1999) "Antitumor activity of thalidomide in refractory multiple myeloma", New Engl. J. Med. 341, 1565-1571]. Moreover, the dose-response relationship has not been defined. We report our use of low dose thalidomide in a small cohort of 12 patients-eight with relapsed or refractory MM and four with plasma cell leukaemia (PCL). Five of the 12 (42%) patients had a partial response, showing a median fall in their PP/BJP of 80% (63-90%) at a median dose of 175 mg (100-300 mg) with negligible side effects. Three of four patients with PCL showed an impressive response to treatment with thalidomide as a single agent. No patient who failed to show any evidence of response at low dose (<150 mg/day) responded to higher doses. In this study, thalidomide induces a similar rate of response at a lower and better tolerated dose than previously reported and produced "best ever" responses in patients with resistant PCL.
authors: Department of Haematology, Imperial College Faculty of Medicine, St Mary's Hospital, London, UK.
authors: R E
authors: RE
authors: Johnston
authors: S H
authors: SH
authors: Abdalla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D010266:Paraproteins / Q000187:drug effects; D016879:Salvage Therapy; D013792:Thalidomide / Q000008:administration & dosage* / Q000633:toxicity; D016896:Treatment Outcome
chemical_list: D010266:Paraproteins; D013792:Thalidomide