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Abstract

Thalidomide and Dexamethasone Induction Therapy Until Best Response in Recently Diagnosed Patients with Multiple Myeloma: Results From a Pilot Study

VOLUME 67 - NUMBER 5 / September - October (Original articles)

Lauro Fabián Amador-Medina, Hospital Regional Alta Especialidad Bajío, León, Gto. México
Dennis Lacayo-Leñero, Department of Hematology and Oncology. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Erick Crespo-Solís, Department of Hematology and Oncology. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Álvaro Aguayo, Department of Hematology and Oncology. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Déborah Martínez-Baños, Department of Hematology and Oncology. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Background: Novel therapies for multiple myeloma are not affordable for all healthcare systems. Objectives: The objectives of this study were to evaluate the response rates, overall survival, event-free survival, and toxicity of thalidomide and dexamethasone administered until best response in recently diagnosed patients with multiple myeloma. Methods: All recently diagnosed multiple myeloma patients meeting the inclusion criteria received the same treatment with thalidomide and dexamethasone. Results: We studied 28 patients. Overall response rate was 75%. Complete response, partial response, and very good partial response were 25.0, 32.1, and 17.9%, respectively. The most frequent adverse event related to therapy was neuropathy. Median overall survival was 66 months, and median event-free survival was 39 months (range, 27.6-50.4). Variables that negatively affected overall survival on multivariate analysis included the presence of extramedullary disease, t(14;16), and chromosome 13 deletion. Conclusions: Induction therapy with thalidomide and dexamethasone until obtaining the best response in patients with recently diagnosed multiple myeloma was a useful and safe strategy. It represents an alternative for patients with limited access to costly drugs.

Keywords: Multiple myeloma. Treatment. Thalidomide. Dexamethasone.

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