title: The efficacy and safety of the low-thalidomide dose CTD (cyclophosphamide, thalidomide, dexamethasone) regimen in patients with multiple myeloma--a report by the Polish Myeloma Study Group.
abstract: Multiple myeloma (MM) remains an incurable disease, but response rates to new drugs are promising, offering the majority of patients a significant prolongation of overall survival. The objective of this study was to evaluate time to progression (TTP), event-free survival (EFS), and overall survival (OS) in MM patients treated with a combination of cyclophosphamide (CY), thalidomide (THAL) and dexamethasone (DEX). This study included 132 untreated and relapsing/resistant patients treated with the low-thalidomide dose CTD regimen. The patients received CY 500 mg/m(2)i.v. or 625 mg/m(2) orally at day 1, THAL 100mg/day á la longue and DEX 20mg/day at days 1-4 and 8-11, every 28 days. Patients received 6-9 cycles; ORR by 3 months was 59.1%, by 6 months 65.6% and by 9 months 75.6%. In patients responding to CTD therapy (CR, nCR, PR), the probability of survival for 20 months was 89.3%. The outpatient low-thalidomide dose CTD regimen is well tolerated and produces a significant response rate both in untreated and relapsing/resistant MM patients.
authors.affiliation: Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland. annadmosz@wp.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Dmoszynska
authors.forename: Adam
authors.initials: A
authors.lastname: Walter-Croneck
authors.forename: Iwona
authors.initials: I
authors.lastname: Hus
authors.forename: Norbert
authors.initials: N
authors.lastname: Grzasko
authors.forename: Joanna
authors.initials: J
authors.lastname: Manko
authors.forename: Wieslaw Wiktor
authors.initials: WW
authors.lastname: Jedrzejczak
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Charlinski
authors.forename: Lidia
authors.initials: L
authors.lastname: Usnarska-Zubkiewicz
authors.forename: Aleksander
authors.initials: A
authors.lastname: Skotnicki
authors.forename: Teresa
authors.initials: T
authors.lastname: Wolska-Smolen
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Piszcz
authors.forename: Janusz
authors.initials: J
authors.lastname: Kloczko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D003520:Cyclophosphamide