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Thalidomide as salvage therapy for VAD-refractory multiple myeloma prior to autologous PBSCT

Bone Marrow Transplantation volume 31, page 1065 (2003)Cite this article

Ahmad et al1 have recently reported their results in four cases of VAD-refractory multiple-myeloma (MM) salvaged with thalidomide (Thal)+VAD followed by peripheral blood stem cell transplantation (PBSCT).

All patients underwent stem cell mobilization with cyclophosphamide (CTX) and GM-CSF. Melphalan was given as conditioning, and all patients engrafted within 12–16 days after PBSCT. Two patients continue to take Thal after a median follow-up of 153 days with no signs of disease progression. They suggest that Thal and other related immunomodulatory drugs may prove useful for initial MM therapy in combination with standard chemotherapy followed by PBSCT. These conclusions must be interpreted with caution. Firstly, when Thal is continued during stem cell mobilization some decrease in circulating peripheral stem cells has been reported. Munshi et al2 have recently reported that when the first 3 days of apheresis were considered the median CD 34+ yield was 5.2 with Thal and 15 without Thal (P=0.01).

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References

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Authors and Affiliations

  1. Department of Oncology, University of Messina, Italy

    V Pitini, C Arrigo, G Aloi & G La Gattuta

  2. Blood Center, University of Messina, Italy

    C Micali

  3. Oncologia Medica e Trapianto di Midollo Osseo Pad. H, 5° piano, Policlinico Universitario, Via Consolare Valeria, Messina, 98125, Italy

    V Pitini

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  1. V Pitini
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Pitini, V., Arrigo, C., Aloi, G. et al. Thalidomide as salvage therapy for VAD-refractory multiple myeloma prior to autologous PBSCT. Bone Marrow Transplant 31, 1065 (2003). https://doi.org/10.1038/sj.bmt.1704079

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