Poor tolerance to high doses of thalidomide in patients with primary systemic amyloidosis.
Treatments effective against multiple myeloma may be useful in primary systemic amyloidosis (AL). Thalidomide is active in myeloma. Results of the first 12 patients enrolled on a phase II trial of thalidomide for AL are presented. Progressive edema, cognitive difficulties, and constipation occurred in approximately 75%; dyspnea, dizziness and rash in 50%. Five developed progressive renal insufficiency. Deep venous thrombosis and syncope each occurred in two. Median time on the study was 72 days, range was 25 to 333 days. All 12 have withdrawn from the study (side-effects, 6; progression, 4; and death, 2 patients). AL patients do not tolerate high dose thalidomide.
Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. dispenzieri.angela@mayo.edu
Angela
A
Dispenzieri
Martha Q
MQ
Lacy
S Vincent
SV
Rajkumar
Susan M
SM
Geyer
Thomas E
TE
Witzig
Rafael
R
Fonseca
John A
JA
Lust
Philip R
PR
Greipp
Robert A
RA
Kyle
Morie A
MA
Gertz
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000188:drug therapy*; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D013792:Thalidomide / Q000008:administration & dosage*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013792:Thalidomide