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Consensus guidelines for the optimal management of adverse events in newly diagnosed, transplant-ineligible patients receiving melphalan and prednisone in combination with thalidomide (MPT) for the treatment of multiple myeloma

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Abstract

Thalidomide has received approval from the European Agency for the Evaluation of Medicinal Products for the treatment of newly diagnosed multiple myeloma (MM) patients older than 65 years or ineligible for transplant. The results of five phase III trials assessing thalidomide in combination with melphalan and prednisone (MPT) have demonstrated significantly improved response rates compared with melphalan and prednisone (MP) alone. Additionally, two of these studies showed that survival was extended by approximately 18 months in patients treated with MPT compared with MP alone. Thalidomide, in combination with MP, is associated with adverse events (AEs) including peripheral neuropathy and venous thromboembolism. In order to optimize the efficacy of MPT, a good awareness of these AEs is imperative. This manuscript outlines both evidence- and consensus-based recommendations discussed by a panel of experts, to provide a practical guide for physicians addressing the effective management of newly diagnosed, transplant-ineligible MM patients receiving thalidomide therapy.

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Acknowledgments

Research support was provided by Celgene Ltd. Editorial support was provided by Dr. Marion James from ScopeMedical Ltd, funded by Celgene Ltd.

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Authors and Affiliations

  1. University of Torino, Turin, Italy

    A. Palumbo

  2. Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK

    F. Davies & G. Morgan

  3. University Clinic of Muenster, Muenster, Germany

    M. Kropff

  4. Hospital Clinic, IDIBAPS, Institut Clinic de Malaties Hematologiques i Oncologiques, Barcelona, Spain

    J. Bladé

  5. Catholic University, Leuven, Belgium

    M. Delforge

  6. Portuguese Institute of Oncology, Lisbon, Portugal

    F. Leal da Costa

  7. Hospital Universitario de Salamanca, Salamanca, Spain

    R. Garcia Sanz

  8. King’s College Hospital, London, UK

    S. Schey

  9. Lille University Hospital, Lille, France

    T. Facon

  10. University of Nantes, Nantes, France

    P. Moreau

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  1. A. Palumbo
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Correspondence to A. Palumbo.

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Palumbo, A., Davies, F., Kropff, M. et al. Consensus guidelines for the optimal management of adverse events in newly diagnosed, transplant-ineligible patients receiving melphalan and prednisone in combination with thalidomide (MPT) for the treatment of multiple myeloma. Ann Hematol 89, 803–811 (2010). https://doi.org/10.1007/s00277-010-0925-1

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