1. First-line thalidomide-dexamethasone therapy in preparation for autologous stem cell transplantation in young patients (<61 years) with symptomatic multiple myeloma.
- Author
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Abdelkefi A, Torjman L, Ben Romdhane N, Ladeb S, El Omri H, Ben Othman T, Elloumi M, Bellaj H, Lakhal A, Jeddi R, Aissaouï L, Saad A, Hsaïri M, Boukef K, Dellagi K, and Ben Abdeladhim A
- Subjects
- Adult, Age Factors, Antigens, CD34 biosynthesis, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Female, Humans, Male, Middle Aged, Prospective Studies, Remission Induction, Stem Cells cytology, Treatment Outcome, Dexamethasone administration & dosage, Glucocorticoids administration & dosage, Hematopoietic Stem Cell Mobilization methods, Immunosuppressive Agents administration & dosage, Multiple Myeloma therapy, Stem Cell Transplantation methods, Thalidomide administration & dosage, Transplantation Conditioning methods
- Abstract
Thalidomide-dexamethasone therapy was given in patients (<61 years) with previously untreated symptomatic multiple myeloma. The aim of this study was to assess the efficacy and toxicity of this combination as first-line therapy, and to determine its effect on stem cell collection and engraftment. During first-line therapy, thalidomide and dexamethasone were administered for 75 days (200 mg/day) and 3 months, respectively. The monthly dose of dexamethasone was 20 mg/m2/day for 4 days, with cycles repeated on days 9 to 12 and 17 to 20 on the first and the third month of therapy. After first-line therapy, a collection of peripheral blood stem cells (PBSC) was performed. Between May 2003 and September 2004, 60 patients were included. On an intent-to-treat basis, the overall response (> or =partial response) rate was 74%, including 24% of patients who obtained a complete remission. Grade 3-4 toxicities consisted of infections (12%), deep-vein thrombosis (3%), constipation (5%), and neuropathy (5%). A total of 58 patients (96%) proceeded to PBSC mobilisation and yielded a median number of 8 x 10(6) CD34+ cells/kg. First-line thalidomide-dexamethasone therapy is effective and relatively well tolerated in young patients with symptomatic multiple myeloma. This combination does not affect PBSC mobilisation.
- Published
- 2005
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