title: Melphalan, prednisone, and thalidomide versus thalidomide, dexamethasone, and pegylated liposomal doxorubicin regimen in very elderly patients with multiple myeloma: a case-match study.
abstract: The outcome of patients with multiple myeloma (MM) aged over 75 years remains poor, and the best therapeutic approach has still to be defined. We compared the response, toxicity, and outcome of 34 very elderly patients with MM receiving thalidomide, dexamethasone, and pegylated liposomal doxorubicin (ThaDD) to those of 34 patients matched for age, International Staging System (ISS), and creatinine who received melphalan, prednisone, thalidomide (MPT). ThaDD resulted in a significantly higher response: > or =PR (87.5% vs. 61.5%, p = 0.009) and > or =VGPR (55.5% vs. 29.5%; p = 0.03). No statistical differences were detected in terms of median probability of progression-free survival (PFS) and overall survival (OS) between the two treatments. Patients treated with MPT had more neutropenia, neuropathy, and heart toxicity, whereas thromboembolism resulted more frequently in patients receiving ThaDD. Therapy discontinuation occurred in 9% and 14.5% of patients treated with ThaDD and MPT, respectively. ThaDD can be considered a therapeutic option in very elderly patients with MM since it induces a faster and deeper response than that obtained with MPT, having similar safety profile.
authors.affiliation: Clinica di Ematologia Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy. m.offidani@ospedaliriuniti.marche.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Offidani
authors.forename: Pietro
authors.initials: P
authors.lastname: Leoni
authors.forename: Sara
authors.initials: S
authors.lastname: Bringhen
authors.forename: Laura
authors.initials: L
authors.lastname: Corvatta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Larocca
authors.forename: Silvia
authors.initials: S
authors.lastname: Gentili
authors.forename: Stefania
authors.initials: S
authors.lastname: Oliva
authors.forename: Claudia
authors.initials: C
authors.lastname: Polloni
authors.forename: Piero
authors.initials: P
authors.lastname: Galieni
authors.forename: Massimo
authors.initials: M
authors.lastname: Catarini
authors.forename: Francesco
authors.initials: F
authors.lastname: Alesiani
authors.forename: Anna
authors.initials: A
authors.lastname: Mele
authors.forename: Marino
authors.initials: M
authors.lastname: Brunori
authors.forename: Nicola
authors.initials: N
authors.lastname: Blasi
authors.forename: Mario
authors.initials: M
authors.lastname: Ferranti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D013792:Thalidomide; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan; D011241:Prednisone