First-line thalidomide-dexamethasone therapy in preparation for autologous stem cell transplantation in young patients (<61 years) with symptomatic multiple myeloma.
Thalidomide-dexamethasone therapy was given in patients (<61 years) with previously untreated symptomatic multiple myeloma. The aim of this study was to assess the efficacy and toxicity of this combination as first-line therapy, and to determine its effect on stem cell collection and engraftment. During first-line therapy, thalidomide and dexamethasone were administered for 75 days (200 mg/day) and 3 months, respectively. The monthly dose of dexamethasone was 20 mg/m2/day for 4 days, with cycles repeated on days 9 to 12 and 17 to 20 on the first and the third month of therapy. After first-line therapy, a collection of peripheral blood stem cells (PBSC) was performed. Between May 2003 and September 2004, 60 patients were included. On an intent-to-treat basis, the overall response (> or =partial response) rate was 74%, including 24% of patients who obtained a complete remission. Grade 3-4 toxicities consisted of infections (12%), deep-vein thrombosis (3%), constipation (5%), and neuropathy (5%). A total of 58 patients (96%) proceeded to PBSC mobilisation and yielded a median number of 8 x 10(6) CD34+ cells/kg. First-line thalidomide-dexamethasone therapy is effective and relatively well tolerated in young patients with symptomatic multiple myeloma. This combination does not affect PBSC mobilisation.
Abdelkefi
A
A
Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia. aabdelkefi@yahoo.fr
Torjman
L
L
Ben Romdhane
N
N
Ladeb
S
S
El Omri
H
H
Ben Othman
T
T
Elloumi
M
M
Bellaj
H
H
Lakhal
A
A
Jeddi
R
R
Aissaouï
L
L
Saad
A
A
Hsaïri
M
M
Boukef
K
K
Dellagi
K
K
Ben Abdeladhim
A
A
D000328:Adult; D000367:Age Factors; D018952:Antigens, CD34 / Q000096:biosynthesis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D011446:Prospective Studies; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000379:methods*; D013234:Stem Cells / Q000166:cytology; D013792:Thalidomide / Q000008:administration & dosage*; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome
D018952:Antigens, CD34; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D013792:Thalidomide; D003907:Dexamethasone