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A Combination of Melphalan, Prednisone, and 50 mg Thalidomide Treatment in Non-Transplant-Candidate Patients with Newly Diagnosed Multiple Myeloma

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Author(s)
Hye Jung ChangJae Hoon LeeYoung Rok DoSung-Hwa BaeJung-Lim LeeSeung Hyun NamSung-Soo YoonSoo-Mee Bang
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Journal of Internal Medicine
Issued Date
2011
Volume
26
Issue
4
Keyword
Multiple myelomaThalidomideMelphalanPrednisone
Abstract
Background/Aims: The clinical efficacy and safety of a three-drug combination of melphalan, prednisone, and thalidomide were assessed in patients with multiple myeloma who were not candidates for high-dose therapy as a firstline treatment. Because the side effects of thalidomide at a dose of ≥ 100 mg daily can be a barrier to effective treatment for these patients, we evaluated the efficacy and safety of a reduced dose of thalidomide, 50 mg, for non-transplant candidates. Methods: Twenty-one patients were treated in 4-week cycles, receiving 4 mg/m2 melphalan and 40 mg/m2 prednisone on days 1-7 and 50 mg thalidomide daily. The primary efficacy outcome was the overall response rate. Aspirin (100 mg daily) was also provided as prophylactic treatment for thromboembolism. Results: The overall response rate was 57.1%; a complete response was seen in 23.8% of patients, a partial response in 33.3%, and stable disease in 9.5%. After a median follow-up time of 16.1 months, the median time to progression was 11.4 months (95% confidence interval, 2.1 to 20.6); the median overall survival was not reached. Grades 3 and 4 adverse events included infection (10%), peripheral neuropathy (5%), diarrhea (5%), thrombosis (10%), and loss of consciousness
(10%). Two patients discontinued treatment due to loss of consciousness and neuropathy. Conclusions: Low-dose thalidomide (50 mg) plus melphalan and prednisone is an effective combination drug therapy option for newly diagnosed myeloma patients who are ineligible for high-dose chemotherapy.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine
Citation
Hye Jung Chang et al. (2011). A Combination of Melphalan, Prednisone, and 50 mg Thalidomide Treatment in Non-Transplant-Candidate Patients with Newly Diagnosed Multiple Myeloma. Korean Journal of Internal Medicine, 26(4), 403–409. doi: 10.3904/kjim.2011.26.4.403
Type
Article
ISSN
1226-3303
DOI
10.3904/kjim.2011.26.4.403
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36089
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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