Long-term outcome in relapsed and refractory multiple myeloma treated with thalidomide. Balancing efficacy and side-effects.
A total of 303 MM patients were retrospectively reviewed to evaluate long-term efficacy and toxicity of thalidomide alone or in combination with steroids. Overall response rate was 57% (CR/VGPR 12%). Median TTP, PFS and OS were 13.4 months, 20.6 months, and 26.2 months, respectively. PFS and OS were significantly different according to response (p < 0.0001), with better outcome in patients achieving CR/VGPR (PFS and OS 35.4 months and 63 months, respectively). PFS and OS of patients achieving SD or PR were overlapping (p = 0.3). The addition of steroids significantly increased the response rate (p = 0.01). The most clinically relevant complications were neuropathy (40%), constipation (26%), thromboembolic events (7%). Thalidomide was reduced for toxicity in 68 patients (24%) and permanently discontinued in 36 (12%). In conclusion, thalidomide produces high response rate in relapsed/refractory MM. The best outcome is observed in patients with good quality response, but even patients with suboptimal response may obtain durable survival.
Corso
Alessandro
A
Divisione di Ematologia, Fondazione IRCCS Policlinico S. Matteo, Università di Pavia, Pavia, Italy. a.corso@smatteo.pv.it
Zappasodi
Patrizia
P
Barbarano
Luciana
L
Petrucci
Maria Teresa
MT
Palumbo
Antonio
A
Caravita
Tommaso
T
Mangiacavalli
Silvia
S
Cafro
Anna Maria
AM
Varettoni
Marzia
M
Gay
Francesca
F
Morra
Enrica
E
Lazzarino
Mario
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D012008:Recurrence; D012189:Retrospective Studies; D013792:Thalidomide / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D013792:Thalidomide