Post-transplant consolidation therapy using thalidomide alone for the patients with multiple myeloma: A feasibility study in Japanese population

Tomoki Ueda, Rioko Iino, Kenji Yokoyama, Shinichiro Okamoto, Keiko Asakura, Yuiko Tsukada, Jo Ishizawa, Eri Matsuki, Yasuo Ikeda, Yutaka Hattori

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Abstract

In order to test for improved survival following autologous transplantation (ASCT), we conducted a prospective clinical trial of post-ASCT thalidomide therapy in Japanese patients with multiple myeloma (MM). Twentyfive newly diagnosed patients received double or single ASCT with high-dose melphalan (200 mg/m2). Two months after stem cell infusion, if the patients failed to achieve a near-complete response, thalidomide was administered at 200 mg/day until disease progression or occurrence of intolerable adverse events. Seventeen patients were in partial response or minimal response after ASCT and received thalidomide alone. Their median progression- free survival (PFS) from ASCT was 17.4 months, and the median overall survival (OS) was 42.9 months. Some patients with normal karyotype experienced durable disease stabilization for over 5 years. Five patients who exhibited high-risk chromosomal changes such as t(4;14) or deletion of chromosome 13 or 17 showed very short PFS and OS compared with those who did not. Observed grade 3 or 4 toxicities included infection in three patients, hematological toxicities in three, and gastrointestinal toxicities in two, but there was no grade 3 or higher peripheral neuropathy, probably due to appropriate dose modifications. This long-term prospective study is the first to demonstrate the feasibility of post-ASCT thalidomide therapy in Japanese patients with MM.

Original languageEnglish
Pages (from-to)477-484
Number of pages8
JournalInternational journal of hematology
Volume96
Issue number4
DOIs
Publication statusPublished - 2012 Oct 1

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Keywords

  • Autologous hematopoietic stem cell transplantation
  • High-risk myeloma
  • Multiple myeloma
  • Post-transplantation therapy
  • Thalidomide

ASJC Scopus subject areas

  • Hematology

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