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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2949-2951. Prepublished online as a Blood First Edition Paper on November 30, 2004; DOI 10.1182/blood-2004-08-3231. This Article Full Text (PDF) All Versions of this Article: 2004-08-3231v1 105/7/2949    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Palladini, G. Articles by Merlini, G. Search for Related Content PubMed PubMed Citation Articles by Palladini, G. Articles by Merlini, G. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 20, 2004 Accepted November 19, 2004 The association of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with AL (primary) amyloidosis Giovanni Palladini, Vittorio Perfetti, Stefano Perlini, Laura Obici, Francesca Lavatelli, Riccardo Caccialanza, Rosangela Invernizzi, Benedetto Comotti, and Giampaolo Merlini* Biotechnology Research Laboratories, Department of Biochemistry, University Hospital IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy; Department of Internal Medicine, University Hospital IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy Department of Internal Medicine, University Hospital IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy Biotechnology Research Laboratories, Department of Biochemistry, University Hospital IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy Department of Applied Health Sciences, Human Nutrition Unit, University Hospital IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy Humanitas-Gavazzeni Clinic, Bergamo, Italy * Corresponding author; email: gmerlini{at}smatteo.pv.it. Based on the efficacy of thalidomide in multiple myeloma and on its synergy with dexamethasone on myeloma plasma cells, we evaluated the combination of thalidomide (100 mg/day, with 100 mg increments every 2 weeks, up to 400 mg) and dexamethasone (20 mg on days 1-4) q21 days, in 31 primary amyloidosis (AL) patients who were refractory to or had relapsed after first-line therapy. Eleven patients (35%) tolerated the 400 mg/day thalidomide. Overall, 15 patients (48%) achieved a hematologic response, with 6 (19%) complete remissions and 8 (26%) organ responses. Median time to response was 3.6 months (range: 2.5-8.0 months). Treatment-related toxicity was frequent (64%), and symptomatic bradycardia was a common (26%) adverse reaction. The association of thalidomide with dexamethasone is rapidly effective and may represent a valuable second-line treatment for AL. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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