title: Low-dose thalidomide in combination with oral fludarabine and cyclophosphamide is ineffective in heavily pre-treated patients with chronic lymphocytic leukemia.
abstract: Elevated levels of TNF-alpha have been associated with progressive disease in patients with chronic lymphocytic leukemia (CLL). Thalidomide has been shown to inhibit production of TNF-alpha. We investigated the effects of thalidomide on clinical outcome and TNF-alpha serum levels in five pre-treated CLL patients. The schedule consisted on daily thalidomide (Thal), oral fludarabine (Flu) and oral cyclophosphamide (CTX). Median duration of treatment was 60 days; four patients stopped treatment for disease progression and one patient for neurological toxicity. Serum TNF-alpha levels did not show any decrease during treatment. Low-dose thalidomide is not effective in CLL patients with refractory disease.
authors.affiliation: Department of Haematology, Catholic University of Sacred Heart of Rome, Italy. l.laurenti@rm.unicatt.it
authors.forename: Luca
authors.initials: L
authors.lastname: Laurenti
authors.forename: Paola
authors.initials: P
authors.lastname: Piccioni
authors.forename: Michela
authors.initials: M
authors.lastname: Tarnani
authors.forename: Laura
authors.initials: L
authors.lastname: De Padua
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Garzia
authors.forename: Dimiter G
authors.initials: DG
authors.lastname: Efremov
authors.forename: Nicola
authors.initials: N
authors.lastname: Piccirillo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Chiusolo
authors.forename: Simona
authors.initials: S
authors.lastname: Sica
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Leone
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013792:Thalidomide / Q000008:administration & dosage* / Q000009:adverse effects; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000097:blood; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D013792:Thalidomide; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine