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Blood, 15 December 2001, Vol. 98, No. 13, pp. 3846-3848
BRIEF REPORT
Salvage therapy for multiple myeloma with thalidomide and CED
chemotherapy
Thomas M. Moehler,
Kai Neben,
Axel Benner,
Gerlinde Egerer,
Fatime Krasniqi,
Anthony D. Ho, and
Hartmut Goldschmidt
From the University of Heidelberg, Department of
Hematology/Oncology/ Rheumatology, and the German Cancer Research
Center, Central Unit Biostatistics, Heidelberg, Germany.
The feasibility and efficacy of a combination of thalidomide,
cyclophosphamide, etoposide, and dexamethasone were studied in 56 patients with poor-prognosis multiple myeloma. Of 50 patients evaluable for response, 4% achieved complete response (CR), 64% partial response (PR), 18% minimal response (MR), 6% stable disease (SD), and 8% progressive disease (PD), resulting in an objective response rate ( MR) of 86.0% (76.7% overall objective response rate
in intent-to-treat analysis; n = 56). Subsequent to successful remission induction, 18 patients received autologous or
allogeneic stem cell transplantation. The median progression-free
survival in all patients was 16 months. The median overall survival
time could not be calculated, since the last observed death occurred after 16 months of follow-up (median follow-up of 14 months) with a
corresponding estimated survival probability of 55%. Severe adverse
effects (World Health Organization III/IV) included infectious complications (35.7%) and cardiovascular events (7.1%). The data suggest that Thal improves antitumor activity of salvage
chemotherapy regimens in poor-prognosis multiple myeloma.
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