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Blood, 15 April 2008, Vol. 111, No. 8, pp. 3968-3977. Prepublished online as a Blood First Edition Paper on February 1, 2008; DOI 10.1182/blood-2007-10-117457. This Article Full Text (PDF) All Versions of this Article: blood-2007-10-117457v1 111/8/3968    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Palumbo, A. Articles by Harousseau, J.-L. Search for Related Content PubMed PubMed Citation Articles by Palumbo, A. Articles by Harousseau, J.-L. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 17, 2007 Accepted December 18, 2007 Thalidomide for treatment of multiple myeloma: 10 years later Antonio Palumbo*, Thierry Facon, Pieter Sonneveld, Joan Blade, Massimo Offidani, Francesca Gay, Philippe Moreau, Anders Waage, Andrew Spencer, Heinz Ludwig, Mario Boccadoro, and Jean-Luc Harousseau Division of Hematology, University of Torino, Azienda Ospedaliera San Giovanni Battista, Torino, Italy University of Lille, Lille, France University Hospital, Erasmus Medical Center, Rotterdam, Netherlands Hematology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain Hematology Clinic, University of Ancona, Ancona, Italy Hematology Department, University Hospital, Nantes, France Department of Haematology, University Hospital Trondheim, Trondheim, Norway Clinical Haematology and BMT, The Alfred Hospital, Melbourne, Australia First Department of Medicine, Center for Oncology and Haematology, Wilhelminenspital, Vienna, Austria Hospital Hotel-Dieu, Nantes Cedex, France * Corresponding author; email: appalumbo{at}yahoo.com. 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 transplant (ASCT). In two randomised studies, consolidation or maintenance with low-dose thalidomide has extended both progression-free and overall survival in patients who received ASCT at diagnosis. In elderly newly diagnosed patients, two independent randomised studies have reported that the oral combination of melphalan and prednisone plus thalidomide (MPT) is better than the standard melphalan and prednisone (MP). These studies have shown better progression-free survival, and two 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. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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