Early response predicts thalidomide efficiency in patients with advanced multiple myeloma

Research output: Contribution to journalArticle

Abstract

Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders (70%) after 3 weeks, and in 20 of 22 responders (91%) after 5 weeks of treatment. Reduction of M protein continued for 3 months and further decline was observed in only four patients. The Hb concentration showed a different time course, with a significant increase after 3 months and further increases continued for up to 12 months. Blood concentration levels of thalidomide from 40 patients were used to evaluate the pharmacokinetics of the drug. Rate of absorption, rate of elimination, volume of distribution, clearance and elimination half-life were calculated to be 0.200/h, 0.140/h, 0.886 l/kg, 0.126 l/h/kg and 4.98 h respectively. We found no relationship between thalidomide concentration and effect after 12 weeks.

Details

Authors
  • A Waage
  • P Gimsing
  • G Juliusson
  • Ingemar Turesson
  • N Gulbrandsen
  • Tommy Eriksson
  • M Hjorth
  • JL Nielsen
  • S Lenhoff
  • Jan Westin
  • F Wisloff
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology

Keywords

  • quality of life, pharmacokinetics, early response, multiple myeloma, thalidomide
Original languageEnglish
Pages (from-to)149-155
JournalBritish Journal of Haematology
Volume125
Issue number2
Publication statusPublished - 2004
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014), Division of Hematology and Transfusion Medicine (013041100), Division of Clinical Chemistry and Pharmacology (013250300), Stem Cell Center (013022011)