title: [Thalidomide therapy in patients with refractory or relapsed multiple myeloma].
abstract: We treated seven refractory or relapsed myeloma patients resistant to conventional chemotherapy with thalidomide. We started thalidomide at 100 mg daily and the dose was increased up to 300 mg if the patient could tolerate it. The patients were evaluated at four weeks and 12 mg of dexamethasone was added for four days when the patient failed to respond to thalidomide treatment. One patient was excluded from the study because of general fatigue. Two of the six patients responded to thalidomide alone and three of the remaining four patients responded to the combination with dexamethasone. The most common adverse effect was sleepiness which was seen in three patients. Two patients showed pancytopenia (Grade 3), constipation and skin eruption. Of the six patients four needed reduction of the thalidomide dose to 200 mg because of adverse effects. Plasma levels of TNF-alpha, IL-6, bFGF and VEGF were measured before and after four weeks. High plasma bFGF levels were seen in responding patients. In conclusion, treatment with thalidomide alone or in combination with dexamethasone is feasible and effective in refractory or relapsed myeloma patients. Further study is required to clarify the role of thalidomide in the therapeutic strategy for multiple myeloma.
authors.affiliation: Kyoto Prefectural University of Medicine, Second Department of Medicine.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ochiai
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shimazaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Uchida
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Fuchida
authors.forename: Akira
authors.initials: A
authors.lastname: Okano
authors.forename: Eishi
authors.initials: E
authors.lastname: Ashihara
authors.forename: Tohru
authors.initials: T
authors.lastname: Inaba
authors.forename: Naohisa
authors.initials: N
authors.lastname: Fujita
authors.forename: Yohko
authors.initials: Y
authors.lastname: Adachi
authors.forename: Akira
authors.initials: A
authors.lastname: Nishio
authors.forename: Masao
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D013792:Thalidomide / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D013792:Thalidomide