Annals of Hematology

, Volume 91, Issue 3, pp 419–426

Long-term results of thalidomide and dexamethasone (thal–dex) as therapy of first relapse in multiple myeloma

  • Elena Zamagni
  • Alessandro Petrucci
  • Patrizia Tosi
  • Paola Tacchetti
  • Giulia Perrone
  • Annamaria Brioli
  • Lucia Pantani
  • Beatrice Zannetti
  • Carolina Terragna
  • Michele Baccarani
  • Michele Cavo
Original Article

DOI: 10.1007/s00277-011-1320-2

Cite this article as:
Zamagni, E., Petrucci, A., Tosi, P. et al. Ann Hematol (2012) 91: 419. doi:10.1007/s00277-011-1320-2

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%).

Keywords

Thalidomide Multiple myeloma First relapse Progression free survival Overall survival Peripheral neuropathy 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Elena Zamagni
    • 1
    • 2
  • Alessandro Petrucci
    • 1
  • Patrizia Tosi
    • 3
  • Paola Tacchetti
    • 1
  • Giulia Perrone
    • 1
  • Annamaria Brioli
    • 1
  • Lucia Pantani
    • 1
  • Beatrice Zannetti
    • 1
  • Carolina Terragna
    • 1
  • Michele Baccarani
    • 1
  • Michele Cavo
    • 1
  1. 1.“Seràgnoli” Institute of HematologyBologna University School of MedicineBolognaItaly
  2. 2.Istituto di Ematologia “Seràgnoli”Università degli Studi di Bologna—Policlinico S.Orsola-MalpighiBolognaItaly
  3. 3.“Infermi” Hospital, Hematology UnitRiminiItaly

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