Abstract
A 52-year-old dentist with kappa light chain multiple myeloma relapsed 6 months after 180 mg/m2 melphalan and an autograft. A partial remission had been attained after the autograft. Relapse occurred while he was on dexamethasone maintenance therapy. Chemotherapy was not an option due to low blood counts. Thalidomide was administered at relatively high doses (escalated up to 700 mg daily and continued for 4 months). There was a prompt decline in urine protein from 6067 mg/day to 2177 mg/day within a month. The response continued to improve with achievement of near-complete remission within 6 months and a decline in urine protein to 413 mg/day. Subsequently, grade 3 neutropenia and peripheral neuropathy required dose reduction to 200 mg/day. Disease activity parameters continued to improve on the lower dose of thalidomide. Nine months after starting thalidomide, the patient is in near-complete remission, enjoys an excellent quality of life, and has returned to work. We conclude that thalidomide can effectively control myeloma relapsing after high-dose chemotherapy, and may be especially useful in resistant cases or those unable to tolerate further chemotherapy. Bone Marrow Transplantation (2000) 25, 1319–1320.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Mehta J, Singhal S . Graft-versus-myeloma Bone Marrow Transplant 1998 22: 835–843
Attal M, Harousseau JL, Stoppa AM et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma New Engl J Med 1996 335: 91–97
Mehta J, Tricot G, Jagannath S et al. Salvage autologous or allogeneic transplantation for multiple myeloma refractory to or relapsing after a first-line autograft? Bone Marrow Transplant 1998 21: 887–892
Singhal S, Mehta J, Desikan R et al. Antitumor activity of thalidomide in refractory multiple myeloma New Engl J Med 1999 341: 1565–1571
D'Amato RJ, Loughman MS, Flynn E, Folkman J . Thalidomide is an inhibitor of angiogenesis Proc Natl Acad Sci USA 1994 91: 4082–4085
Vacca A, Ribatti D, Presta M et al. Bone marrow neovascularization, plasma cell angiogenic potential, and matrixmetalloproteinase-2 secretion parallel progression of humanmultiple myeloma Blood 1999 93: 3064–3073
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Zomas, A., Anagnostopoulos, N. & Dimopoulos, M. Successful treatment of multiple myeloma relapsing after high-dose therapy and autologous transplantation with thalidomide as a single agent. Bone Marrow Transplant 25, 1319–1320 (2000). https://doi.org/10.1038/sj.bmt.1702444
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702444
Keywords
This article is cited by
-
Phase I study to determine the safety, tolerability and immunostimulatory activity of thalidomide analogue CC-5013 in patients with metastatic malignant melanoma and other advanced cancers
British Journal of Cancer (2004)
-
Response to single-agent thalidomide and eligibility to undergo autotransplant for patients with multiple myeloma refractory to VAD
Bone Marrow Transplantation (2003)
-
Clinical translation of angiogenesis inhibitors
Nature Reviews Cancer (2002)
-
Thalidomide as salvage therapy for VAD-refractory multiple myeloma prior to autologous PBSCT
Bone Marrow Transplantation (2002)
-
Angiogenesis in Hematologic Malignancies and Its Clinical Implications
International Journal of Hematology (2002)