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The oral combination of thalidomide, cyclophosphamide and dexamethasone (ThaCyDex) is effective in relapsed/refractory multiple myeloma

Leukemia volume 18, pages 856–863 (2004)Cite this article

Abstract

We evaluate the efficacy of the oral combination of thalidomide, cyclophosphamide and dexamethasone (ThaCyDex) in 71 refractory/relapsed multiple myeloma patients, including a prognostic analysis to predict both response and survival. Patients received thalidomide at escalating doses (200–800 mg/day), daily cyclophosphamide (50 mg/day) and pulsed dexamethasone (40 mg/day, 4 days every 3 weeks). On an intention-to-treat basis and using the EBMT response criteria, 2% patients reached complete response (CR), 55% partial response (PR) and 26% minor response (MR) yielding a total response (CR+PR+MR) rate of 83% after 3 months of therapy. After 6 months of therapy, responses were maintained including a 10% CR. The 2-year progression free and overall survival were 57 and 66%, respectively. A favorable response was associated with β2 microglobulin ⩽4 mg/dl, platelets >80 × 109/l and nonrefractory disease. Regarding survival, low β2 microglobulin (⩽4 mg/dl), age (⩽65 years) and absence of extramedullary myelomatous lesion were associated with a longer survival. Major adverse effects included constipation (24%), somnolence (18%), fatigue (17%) and infection (13%). Only 7% of patients developed a thrombo-embolic event. ThaCyDex is an oral regimen that induces a high response rate and long remissions, particularly in relapsing patients with β2 microglobulin ⩽4 mg/dl and ⩽65 years.

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Authors and Affiliations

  1. Grupo Español de Mieloma (GEM), Red Española de Mieloma (G03/136), FIS-SS PI-02/0905,

    R García-Sanz, J R González-Porras, J M Hernández, M Polo-Zarzuela, A Sureda, C Barrenetxea, L Palomera, R López, C Grande-García, A Alegre, M Vargas-Pabón, O N Gutiérrez, J A Rodríguez & J F San Miguel

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García-Sanz, R., González-Porras, J., Hernández, J. et al. The oral combination of thalidomide, cyclophosphamide and dexamethasone (ThaCyDex) is effective in relapsed/refractory multiple myeloma. Leukemia 18, 856–863 (2004). https://doi.org/10.1038/sj.leu.2403322

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