title: Possible multiple myeloma dedifferentiation following thalidomide therapy: a report of four cases.
abstract: Thalidomide has been shown to be effective in approximately 30% of patients with refractory or advanced multiple myeloma (MM). Here we report on 4 cases of patients treated with thalidomide for refractory MM showing dedifferentiation of the neoplasm. In these cases thalidomide treatment despite reduction of M-component-was followed by disease progression and a very poor clinical outcome which was paralleled by bone marrow plasmacytosis showing marked signs of dedifferentiation, inducing us to speculate on a potential role of thalidomide on dedifferentiation of myeloma cells. In our opinion, a possible dedifferentiation of MM should therefore be taken into account in MM patients treated with thalidomide when clinical course deteriorates despite reduction of M-component.
authors.affiliation: Department of Internal Medicine, Haematology-Oncology Section, University of Genoa, Genoa, Italy. balleari@unige.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Balleari
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ghio
authors.forename: Antonietta
authors.initials: A
authors.lastname: Falcone
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation / Q000187:drug effects; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology*; D009194:Myeloma Proteins; D013792:Thalidomide / Q000494:pharmacology* / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D009194:Myeloma Proteins; D013792:Thalidomide