title: Long-term results of thalidomide and dexamethasone (thal-dex) as therapy of first relapse in multiple myeloma.
abstract: Thal-dex (TD) is an effective therapy for advanced MM. We evaluated TD as salvage treatment of MM patients at first relapse. Thal was given at a daily dose of 100 or 200 mg until progression. Dex was administered 160 mg/month. One hundred patients were enrolled. First line therapy included ASCT (72%) and conventional CHT (28%). Fifty-nine percent received a fixed thal dose of 100 mg/day. The most frequent adverse events were constipation (42%), peripheral neuropathy (58%, 5% grade 3), bradycardia (20%), skin rash (11%), and VTE (7%). Discontinuation of thal due to adverse events was recorded in eight patients. On ITT, 46% of patients achieved at least a PR. Median DOR was 28 months, median time to next therapy was 15.5 months. Median OS, TTP, and PFS were 43, 22, and 21 months, respectively. TTP and PFS were significantly longer for patients with at least PR to TD. TD was an effective salvage treatment for MM patients at first relapse, as demonstrated by durable disease control and prolonged OS. TD was well tolerated, as reflected by the long stay on treatment without disease progression (median 25 months) and a low discontinuation rate due to toxicity (8%).
authors: "Seràgnoli" Institute of Hematology, Bologna University School of Medicine, Bologna, Italy. e.zamagni@unibo.it
authors: Elena
authors: E
authors: Zamagni
authors: Alessandro
authors: A
authors: Petrucci
authors: Patrizia
authors: P
authors: Tosi
authors: Paola
authors: P
authors: Tacchetti
authors: Giulia
authors: G
authors: Perrone
authors: Annamaria
authors: A
authors: Brioli
authors: Lucia
authors: L
authors: Pantani
authors: Beatrice
authors: B
authors: Zannetti
authors: Carolina
authors: C
authors: Terragna
authors: Michele
authors: M
authors: Baccarani
authors: Michele
authors: M
authors: Cavo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000517:prevention & control*; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D013792:Thalidomide / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D018931:Antineoplastic Agents, Hormonal; D013792:Thalidomide; D003907:Dexamethasone