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Long term use of thalidomide: Safe and effective

Author(s): Sharma A | Raina V | Uppal G | Kumar R | Grover J

Journal: Indian Journal of Cancer
ISSN 0019-509X

Volume: 44;
Issue: 3;
Start page: 108;
Date: 2007;
Original page

Keywords: Multiple myeloma | relapse | thalidomide

Purpose : To assess the efficacy and safety of high dose thalidomide therapy for longer duration of time in relapsed or refractory Multiple Myeloma (MM) patients. Materials and Methods : Twelve relapsed/refractory MM patients (7 Males, 5 Females), who received thalidomide for more than 2 years were selected from the Out Patient Department of Institute Rotary Cancer Hospital (IRCH), AIIMS, India. Patients received thalidomide beginning at a dose of 200 mg/day with fortnightly increment to a maximum dose of 800 mg/day. Patients were assessed for response on the basis of M proteins (MP), bone marrow biopsy with touch preparation and skeletal X-rays. Results : Nine patients tolerated a maximum dose of 800 mg/day whereas three patients were given 600 mg/day. All patients showed ≥ 25-50% decline in serum /urine M proteins. Complete response/ near complete response was seen in 50%, partial response in 17% and minimal response (SD) in 34% patients. Median duration of thalidomide therapy was 47 months (range 29-60 months). Currently 11 patients are alive. Toxicity : Varying degree of constipation and sedation were seen universally. One patient had DVT, which responded to anti-coagulant therapy. Other toxic effects included infections, skin reactions. There was no toxic death. Conclusion : long-term use of thalidomide is safe, effective and feasible. We feel that this is one of few reports describing safety and efficacy of long-term thalidomide in relapsed and refractory MM.
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