First thalidomide clinical trial in multiple myeloma: a decade.
The clinical outcomes of 169 patients enrolled in the first clinical trial of thalidomide for advanced or refractory myeloma are updated. Seventeen patients remain alive and 10 are event-free, with a median follow-up of 9.2 years. According to multivariate analysis of pretreatment variables, cytogenetic abnormalities, present in 47% of patients within 3 months of enrollment, and lambda light chain isotype both affected overall survival and event-free survival adversely. Forty percent of the 58 patients lacking these 2 unfavorable features, one-half of whom had no disease recurrence, survived at least 6 years, in contrast to fewer than 5% among those with 1 or 2 risk features (P < .001). Patients who had received cumulative thalidomide doses in excess of 42 g in the first 3 months enjoyed superior overall and event-free survival. The poor outcome associated with lambda-type myeloma may relate to its overrepresentation in molecularly defined high-risk disease gleaned from studies in newly diagnosed myeloma.
van Rhee
Frits
F
Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Dhodapkar
Madhav
M
Shaughnessy
John D
JD
Anaissie
Elias
E
Siegel
David
D
Hoering
Antje
A
Zeldis
Jerome
J
Jenkins
Bonnie
B
Singhal
Seema
S
Mehta
Jayesh
J
Crowley
John
J
Jagannath
Sundar
S
Barlogie
Bart
B
D002869:Chromosome Aberrations; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007146:Immunoglobulin lambda-Chains; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage* / Q000633:toxicity; D016896:Treatment Outcome
D007146:Immunoglobulin lambda-Chains; D013792:Thalidomide