title: Biologically defined risk groups can be used to define the impact of thalidomide maintenance therapy in newly diagnosed multiple myeloma.
abstract: Maintenance therapy is an attractive strategy for patients with multiple myeloma. However, the impact of maintenance thalidomide according to the underlying biology of the disease is still a matter of debate, with some studies suggesting that thalidomide is more beneficial in high risk disease, whilst others show the opposite. Biological risk groups defined by interphase fluorescence in situ hybridization (FISH) are powerful predictors of outcome. In this report we investigated the effect of maintenance thalidomide in different biological risk groups defined by different FISH categories. Our data show that maintenance thalidomide improves outcome in patients with biologically low risk disease, defined by the absence of adverse cytogenetic lesion or by the presence of hyperdiploidy alone. Conversely, thalidomide maintenance is detrimental for the overall survival of patients with biological high risk. We conclude that it is important to identify biologically low risk patients who will benefit from a maintenance strategy with thalidomide.
authors.affiliation: Haemato-Oncology Research Unit, Division of Molecular Pathology, The Institute of Cancer Research, London, UK.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Brioli
authors.forename: Martin F
authors.initials: MF
authors.lastname: Kaiser
authors.forename: Charlotte
authors.initials: C
authors.lastname: Pawlyn
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.forename: Walter M
authors.initials: WM
authors.lastname: Gregory
authors.forename: Roger
authors.initials: R
authors.lastname: Owen
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Ross
authors.forename: Graham H
authors.initials: GH
authors.lastname: Jackson
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Faith E
authors.initials: FE
authors.lastname: Davies
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morgan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017404:In Situ Hybridization, Fluorescence; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D009367:Neoplasm Staging; D013792:Thalidomide / Q000627:therapeutic use*; D014178:Translocation, Genetic; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013792:Thalidomide