title: Bleeding recurrence in patients with gastrointestinal vascular malformation after thalidomide.
abstract: Thalidomide may be used for the treatment of gastrointestinal vascular malformation (GIVM), but the long-term response and adverse effects are unknown. Aim to study the recurrence rate of GIVM bleeding after thalidomide treatment, the response to treatment, and the adverse effects.This was a retrospective study of 80 patients with GIVM treated with thalidomide between November 2003 and November 2013. Patients received a course of 100 mg/day of thalidomide for 4 months and were followed up for at least 1 year. The response rate during follow-up, the recurrence rate after the 1st course of treatment, and the rate of retreatment were assessed. Comorbidities, the need for blood transfusion, yearly bleeding episodes, hemoglobin levels, hospitalization after thalidomide treatment, and the rate of adverse effects were also examined.The overall response rate during follow-up was 79.5% (62/78). The recurrence rate was 21.0% after the 1st course of thalidomide. The response rate of retreatment was 100%. After thalidomide treatment, yearly blood transfusion amounts, yearly bleeding episodes, and yearly hospitalization numbers were significantly decreased, while hemoglobin levels were significantly increased (P < 0.001). Adverse effects were observed in 60.0% (48/80) of the patients. Serious adverse effects were reported in 31.3% (25/80). The overall response rate was 76.7% (23/30) in 30 patients with comorbidities, while the rate was 78.0% (39/50) in patients without comorbidities (P = 0.55). The rate of serious adverse effects was similar between the comorbidities (33.3%) and no-comorbidities groups (30.0%) (P = 0.76).Thalidomide showed a good response rate and low adverse effect rate in patients with recurrent gastrointestinal bleeding due to GIVM.
authors.affiliation: Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao-Tong University, Shanghai, China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.forename: Sengwang
authors.initials: S
authors.lastname: Fu
authors.forename: Nan
authors.initials: N
authors.lastname: Feng
authors.forename: Huimin
authors.initials: H
authors.lastname: Chen
authors.forename: Yunjie
authors.initials: Y
authors.lastname: Gao
authors.forename: Yunjia
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hanbing
authors.initials: H
authors.lastname: Xue
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Dai
authors.forename: Jingyuan
authors.initials: J
authors.lastname: Fang
authors.forename: Zhizheng
authors.initials: Z
authors.lastname: Ge
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy; D041981:Gastrointestinal Tract / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013792:Thalidomide / Q000627:therapeutic use*; D054079:Vascular Malformations / Q000150:complications / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide