Clinical Efficacy of Thalidomide Containing Regimens as a Primary Therapy in Patients with Multiple Myeloma

Background: The aim of this study was to assess the efficacy and toxicity of thalidomide-containing regimens as the first-line therapy for patients with multiple myeloma. Methods: A total of 60 patients were initially treated with thalidomide-containing regimens at three institutions. Thalidomide was given with two different regimens: the TD regimen (thalidomide and dexamethasone) and the TCD regimen (thalidomide, cyclophosphamide, and dexamethasone). Autologous peripheral blood stem cells (PBSC) were collected after mobilizing with G-CSF with or without cyclophosphamide. Results: Of all the patients, 56 patients (TD regimen: 12 patients, TCD regimen: 44 patients) who received at least 4 cycles or more were evaluated for response and toxicity. The median age of the patients was 65.5 years (age range: 39~80 years). The overall response rate for the thalidomide-containing regimens was 85.5%. There were 3 (25%) complete responses and 6 (50%) partial responses for the TD regimen and there were 17 (38.6%) complete responses and 21 (47.7%) partial responses for the TCD regimen, respectively. The toxicity, according to the NCI-CTC (grade 3/4) included neutropenia in 7 patients (12.5%), thrombocytopenia in 4 patients (7.1%), infection in 6 patients (10.7%) and neuropathy in 10 patients (17.8%). In addition, there were 2 patients (3.6%) with thrombosis. Thirteen patients, who achieved more than a partial response to the thalidomide-containing regimen, proceeded to PBSC collection and the median number of CD34 + cells collected was 3.8×10 6 /kg.