Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 139, Issue 3, Pages 429-433Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1365-2141.2007.06817.x
Keywords
thalidomide; myeloma; maintenance; stem cell transplantation; toxicity
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Thalidomide maintenance has unresolved issues regarding dosage and toxicity. We evaluated this in five dose cohorts in 100 patients. At a median follow-up of 32.3 months, 23 patients had stopped thalidomide for disease progression, 54 for side effects. 3-year overall and progression-free survival was 76% and 41% respectively. Dosage did not influence disease outcome but greatly affected toxicity. Fifteen patients converted from partial remission to complete remission on thalidomide at a median of 13.5 months. Maintenance doses > 200 mg were largely unachievable and peripheral neuropathy was the main toxicity. Lower doses enabled more patients to stay on the drug for a useful period of time.
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