Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Single-agent thalidomide for treatment of first relapse following high-dose chemotherapy in patients with multiple myeloma

Leukemia volume 19, pages 156–159 (2005)Cite this article

TO THE EDITOR

The use of thalidomide has improved the treatment of patients with multiple myeloma (MM). Thalidomide has shown to have therapeutic activity as a single agent in patients with relapsed and/or refractory MM.1, 2 Thalidomide monotherapy can induce remissions in about one-third of relapsing or refractory patients1, 2, 4, 5, 6, 7, 8 and combinations of thalidomide with dexamethasone and/or chemotherapy can further improve response rates in these patients.1, 2, 3 Abnormal cytogenetics, high plasma cell labeling index, IgA isotype, high levels of LDH or beta2-microglobulin as well as low hemoglobulin, platelet count or albumin have been identified in different studies as adverse prognostic factors for outcome after treatment with thalidomide in patients with relapsed or refractory MM.4, 5, 6, 7, 8 Apart from results of patients with advanced and heavily pretreated disease, studies have shown efficiency of thalidomide treatment in untreated patients.1, 2 Currently, data of an early patient population, who are neither untreated nor heavily pretreated, are very limited. Several groups have studied patients with relapsed or refractory MM,1, 2, 4, 5, 6, 7, 8 but the patient populations were widely heterogeneous including patients with first relapse and patients with later relapse after more than 5 years of prior therapy. Patients with relapse off treatment, primary refractory disease and refractory relapse were mixed as well as patients with prior high-dose chemotherapy (HDT) and patients who had received only conventional chemotherapy. Thus, it is very difficult to define the role of thalidomide for the individual patient.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Dimopoulos MA, Anagnostopoulos A, Weber D . Treatment of plasma cell dyscrasias with thalidomide and its derivates. J Clin Oncol 2003; 21: 4444–4454.

    Article  CAS  Google Scholar 

  2. Cavenagh JD, Oakervee H . UK Myeloma Forum and the BCSH Haematology/Oncology Task Forces. Thalidomide in multiple myeloma: current status and future prospects. Br J Haematol 2003; 120: 18–26.

    Article  CAS  Google Scholar 

  3. Kropff MH, Lang N, Bisping G, Domine N, Innig G, Hentrich M et al. Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma. Br J Haematol 2003; 122: 607–616.

    Article  CAS  Google Scholar 

  4. Barlogie B, Desikan R, Eddlemon P, Spencer T, Zeldis J, Munshi N et al. Extended survival in advanced and refractory multiple myeloma after single-agent thalidomide: identification of prognostic factors in a phase 2 study of 169 patients. Blood 2001; 98: 492–494.

    Article  CAS  Google Scholar 

  5. Yakoub-Agha I, Attal M, Dumontet C, Delannoy V, Moreau P, Berthou C et al. Thalidomide in patients with advanced multiple myeloma: a study of 83 patients – report of the Intergroupe Francophone du Myelome (IFM). Hematol J 2002; 3: 185–192.

    Article  CAS  Google Scholar 

  6. Neben K, Moehler T, Benner A, Kraemer A, Egerer G, Ho AD et al. Dose-dependent effect of thalidomide on overall survival in relapsed multiple myeloma. Clin Cancer Res 2002; 8: 3377–3382.

    CAS  PubMed  Google Scholar 

  7. Kumar S, Gertz MA, Dispenzieri A, Lacy MQ, Geyer SM, Iturria NL et al. Response rate, durability of response, and survival after thalidomide therapy for relapsed multiple myeloma. Mayo Clin Proc 2003; 78: 34–39.

    Article  Google Scholar 

  8. Mileshkin L, Biagi JJ, Mitchell P, Underhill C, Grigg A, Bell R et al. Multicenter phase 2 trial of thalidomide in relapsed/refractory multiple myeloma: adverse prognostic impact of advanced age. Blood 2003; 102: 69–77.

    Article  CAS  Google Scholar 

  9. Schey SA, Cavenagh J, Johnson R, Child JA, Oakervee H, Jones RW . An UK myeloma forum phase II study of thalidomide: long term follow-up and recommendations for treatment. Leukemia Res 2003; 27: 909–914.

    Article  CAS  Google Scholar 

  10. Palumbo A, Bertola A, Falco P, Rosato R, Cavallo F, Giaccone L et al. Efficacy of low-dose thalidomide and dexamethasone as first salvage regimen in multiple myeloma. Hematol J 2004; 5: 318–324.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by Leukämie Liga e.V.

Author information

Authors and Affiliations

  1. Department of Hematology, Oncology and Clinical, Immunology, University of Duesseldorf, Germany

    R Fenk, B Hoyer, U Steidl, M Kondakci, T Graef, R Heuk, L Ruf, C Strupp, F Neumann, U-P Rohr, R Haas & G Kobbe

  2. Hematology/Oncology Division, Harvard Institutes of Medicine, Boston, USA

    U Steidl

  3. Department of Human Genetics and Anthropology, University of Duesseldorf, Germany

    B Hildebrandt

Authors
  1. R Fenk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B Hoyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U Steidl
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Kondakci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T Graef
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Heuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L Ruf
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C Strupp
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. F Neumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. U-P Rohr
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. B Hildebrandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. R Haas
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. G Kobbe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R Fenk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fenk, R., Hoyer, B., Steidl, U. et al. Single-agent thalidomide for treatment of first relapse following high-dose chemotherapy in patients with multiple myeloma. Leukemia 19, 156–159 (2005). https://doi.org/10.1038/sj.leu.2403564

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2403564

Search

Advanced search

Quick links