Maintenance thalidomide following single cycle autologous peripheral blood stem cell transplant in patients with multiple myeloma

Although autologous stem cell transplant is an effective therapy for patients with multiple myeloma and extends progression-free survival (PFS) and overall survival (OS), patients show a continued pattern of recurrent disease. Twenty-nine patients were enrolled in a phase II study investigating the...

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Bibliographic Details
Published in:	Bone marrow transplantation (Basingstoke) Vol. 37; no. 9; pp. 825 - 829
Main Authors:	SAHEBI, F, SPIELBERGER, R, POPPLEWELL, L, FRANKEL, P, RUEL, C, TIN, R, ILIEVA, P, FORMAN, S. J, SOMLO, G, KOGUT, N. M, FUNG, H, FALK, P. M, PARKER, P, KRISHNAN, A, RODRIGUEZ, R, NAKAMURA, R, NADEMANEE, A
Format:	Journal Article
Language:	English
Published:	Basingstoke Nature Publishing Group 01-05-2006
Subjects:	Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Angiogenesis Inhibitors - therapeutic use Autografts Biological and medical sciences Blood Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Combined Modality Therapy Disease Progression Dosage and administration Female Health aspects Hematopoietic stem cells Humans Immunodeficiencies. Immunoglobulinopathies Immunoglobulinopathies Immunopathology Maintenance Male Medical sciences Middle Aged Multiple myeloma Multiple Myeloma - blood supply Multiple Myeloma - drug therapy Multiple Myeloma - mortality Multiple Myeloma - pathology Multiple Myeloma - therapy Neoplasm Staging Peripheral blood Remission Remission (Medicine) Stem cell transplantation Stem Cell Transplantation - adverse effects Stem cells Survival Survival Analysis Survivors Thalidomide Thalidomide - therapeutic use Thalidomide - toxicity Time Factors Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation, Autologous Treatment Outcome United States Antineoplastic agent Human Immunopathology multiple myeloma Antileprous agent Hematology Stem cell Hematopoietic cell Hypnotic Malignant hemopathy Myeloma Cycle Blood autologous stem cell transplant Autograft Immunoglobulinopathy Lymphoproliferative syndrome Graft Sedative Antiangiogenic agent Antibacterial agent Thalidomide maintenance
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Summary:	Although autologous stem cell transplant is an effective therapy for patients with multiple myeloma and extends progression-free survival (PFS) and overall survival (OS), patients show a continued pattern of recurrent disease. Twenty-nine patients were enrolled in a phase II study investigating the tolerability and efficacy of maintenance thalidomide following single autologous peripheral blood stem cell transplant. Six to eight weeks after transplant, patients were started on maintenance thalidomide at 50 mg a day. The dose was gradually escalated to a target dose of 400 mg a day and continued until disease progression or 6 months after achieving complete remission (CR) for a maximum total duration of 18 months. At 6 months, 13 patients (45%) achieved CR or near complete remission (positive immunofixation without any evidence of disease). The estimated 2-year OS was 83% and PFS was 49%. Median tolerated dose of thalidomide was 200 mg a day. In conclusion, thalidomide as maintenance therapy is feasible and may improve outcome after single autologous stem cell transplant.
ISSN:	0268-3369 1476-5365
DOI:	10.1038/sj.bmt.1705339