Thalidomide for treatment of multiple myeloma : 10 years later
Identifieur interne : 008996 ( Main/Exploration ); précédent : 008995; suivant : 008997Thalidomide for treatment of multiple myeloma : 10 years later
Auteurs : Antonio Palumbo [Italie] ; Thierry Facon [France] ; Pieter Sonneveld [Pays-Bas] ; Joan Blade [Espagne] ; Massimo Offidani [Italie] ; Francesca Gay [Italie] ; Philippe Moreau [France] ; Anders Waage [Norvège] ; Andrew Spencer [Australie] ; Heinz Ludwig [Autriche] ; Mario Boccadoro [Italie] ; Jean-Luc Harousseau [France]Source :
- Blood [ 0006-4971 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Thalidomide, bortezomib, and lenalidomide have recently changed the treatment paradigm of myeloma. In young, newly diagnosed patients, the combination of thalidomide and dexamethasone has been widely used as induction treatment before autologous stem cell transplantation (ASCT). In 2 randomized studies, consolidation or maintenance with low-dose thalidomide has extended both progression-free and overall survival in patients who underwent ASCT at diagnosis. In elderly, newly diagnosed patients, 3 independent randomized studies have reported that the oral combination of melphalan and prednisone plus thalidomide (MPT) is better than the standard melphaIan and prednisone (MP). These studies have shown better progression-free survival, and 2 have shown improved overall survival for patients assigned to MPT. In refractory-relapsed disease, combinations including thalidomide with dexamethasone, melphalan, doxorubicin, or cyclophosphamide have been extensively investigated. The risks of side effects are greater when thalidomide is used in combination with other drugs. Thromboembolism and peripheral neuropathy are the major concern. The introduction of anticoagulant prophylaxis has reduced the rate of thromboembolism to less than 10%. Immediate thalidomide dose reduction or discontinuation when paresthesia is complicated by pain or motor deficit has decreased the severity of neuropathy. Future studies will define the most effective or the best sequence of combinations which could improve life expectancy.
Affiliations:
- Australie, Autriche, Espagne, France, Italie, Norvège, Pays-Bas
- Catalogne, Hauts-de-France, Hollande-Méridionale, Nord-Pas-de-Calais, Pays de la Loire, Piémont, Trøndelag, Victoria (État), Vienne (Autriche)
- Barcelone, Lille, Melbourne, Nantes, Rotterdam, Trondheim, Turin, Vienne (Autriche)
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 003465
- to stream PascalFrancis, to step Curation: 002B84
- to stream PascalFrancis, to step Checkpoint: 002E58
- to stream Main, to step Merge: 009272
- to stream Main, to step Curation: 008996
Le document en format XML
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<s3>AUS</s3>
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<author><name sortKey="Ludwig, Heinz" sort="Ludwig, Heinz" uniqKey="Ludwig H" first="Heinz" last="Ludwig">Heinz Ludwig</name>
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<author><name sortKey="Boccadoro, Mario" sort="Boccadoro, Mario" uniqKey="Boccadoro M" first="Mario" last="Boccadoro">Mario Boccadoro</name>
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<author><name sortKey="Harousseau, Jean Luc" sort="Harousseau, Jean Luc" uniqKey="Harousseau J" first="Jean-Luc" last="Harousseau">Jean-Luc Harousseau</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antineoplastic agent</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Thalidomide</term>
<term>Traitement</term>
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<front><div type="abstract" xml:lang="en">Thalidomide, bortezomib, and lenalidomide have recently changed the treatment paradigm of myeloma. In young, newly diagnosed patients, the combination of thalidomide and dexamethasone has been widely used as induction treatment before autologous stem cell transplantation (ASCT). In 2 randomized studies, consolidation or maintenance with low-dose thalidomide has extended both progression-free and overall survival in patients who underwent ASCT at diagnosis. In elderly, newly diagnosed patients, 3 independent randomized studies have reported that the oral combination of melphalan and prednisone plus thalidomide (MPT) is better than the standard melphaIan and prednisone (MP). These studies have shown better progression-free survival, and 2 have shown improved overall survival for patients assigned to MPT. In refractory-relapsed disease, combinations including thalidomide with dexamethasone, melphalan, doxorubicin, or cyclophosphamide have been extensively investigated. The risks of side effects are greater when thalidomide is used in combination with other drugs. Thromboembolism and peripheral neuropathy are the major concern. The introduction of anticoagulant prophylaxis has reduced the rate of thromboembolism to less than 10%. Immediate thalidomide dose reduction or discontinuation when paresthesia is complicated by pain or motor deficit has decreased the severity of neuropathy. Future studies will define the most effective or the best sequence of combinations which could improve life expectancy.</div>
</front>
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