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Low tolerance and high toxicity of thalidomide as maintenance therapy after double autologous stem cell transplant in multiple myeloma patients.
- Source :
-
European journal of haematology [Eur J Haematol] 2007 Jan; Vol. 78 (1), pp. 35-40. Date of Electronic Publication: 2006 Oct 17. - Publication Year :
- 2007
-
Abstract
- Although a double autologous peripheral blood stem cell transplant (APBSCT) is an effective therapy for patients (pts) with multiple myeloma and extends progression-free survival and overall survival, pts show a continued pattern of recurrent disease. The feasibility and tolerability of thalidomide (Thal) administered in the post-transplantation period as maintenance therapy was tested in 17 pts at a dose of 100 mg/d starting between 3 and 5 months after the second transplantation and continuing either until toxicity precluded further therapy or until pts had disease progression. After a median administration of 13 months (range: 3-26), 76.5% (13 pts) failed to tolerate Thal because of: transiet ischemic attack (three pts), severe fatigue (two), neutropenia (one), piastrinopenia (one), severe opportunistic infectious (two), erectile impotence (one), gastrointestinal toxicity (anorexia with weight loss one), peripheral neuropathy (two). After a median follow-up of 36 months (range: 10-59) from the second transplant, 13 patients attained a CR + near CR (with a conversion rate from 47.1% to 76.5%). In conclusion, Thal as maintenance therapy after double ASCT is associated with low feasibility and high toxicity and could prevent a lengthy use of this antineoplastic agent.
- Subjects :
- Adult
Disease Progression
Disease-Free Survival
Dose-Response Relationship, Drug
Drug Tolerance
Female
Humans
Male
Middle Aged
Survival Rate
Transplantation, Autologous
Treatment Outcome
Antineoplastic Agents adverse effects
Hematopoietic Stem Cell Transplantation
Multiple Myeloma therapy
Thalidomide adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0902-4441
- Volume :
- 78
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 17042773
- Full Text :
- https://doi.org/10.1111/j.1600-0609.2006.00774.x