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Blood, 15 October 2008, Vol. 112, No. 8, pp. 3122-3125. Prepublished online as a Blood First Edition Paper on July 31, 2008; DOI 10.1182/blood-2008-06-164228. This Article Full Text (PDF) All Versions of this Article: blood-2008-06-164228v1 112/8/3122    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 Barlogie, B. Articles by Zeldis, J. B. Search for Related Content PubMed PubMed Citation Articles by Barlogie, B. Articles by Zeldis, J. B. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted June 23, 2008 Accepted July 18, 2008 Seven year median time to progression with thalidomide for smoldering myeloma: Partial response identifies subset requiring earlier salvage therapy for symptomatic disease Bart Barlogie*, Frits van Rhee, John D Shaughnessy Jr, Joshua Epstein, Shmuel Yaccoby, Mauricio Pineda-Roman, Klaus Hollmig, Yazan Alsayed, Antje Hoering, Jackie Szymonifka, Elias Anaissie, Nathan Petty, Naveen S Kumar, Geetika Srivastava, Bonnie Jenkins, John Crowley, and Jerome B. Zeldis Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, United States Cancer Research and Biostatistics, Seattle, WA, United States Celgene Corporation, Summit, NJ, United States * Corresponding author; email: barlogiebart{at}uams.edu. Smoldering multiple myeloma (SMM) is usually followed expectantly without therapy. We conducted a phase II trial in 76 eligible patients with SMM, combining thalidomide (THAL, 200mg/d) with monthly pamidronate. In the first 2 years, THAL dose reduction was required in 86% and drug was discontinued in 50%. Within 4 years, 63% improved including 25% qualifying for partial response (PR); by then, 34 patients had progressed and 17 required salvage therapy. Unexpectedly, attaining PR status was associated with a shorter time to salvage therapy for disease progression (p<0.001), perhaps reflecting greater drug sensitivity of more aggressive disease. Low beta-2-microglobulin levels <2mg/L were independently associated with superior overall and event-free survival. Four-year survival and event-free survival estimates of 91% and 60% together with a median post-salvage therapy survival of more than 5 years justify the conduct of a prospective randomized clinical trial to determine the clinical value of pre-emptive therapy in SMM. Trial registered at http://www.clinicaltrials.gov under identifier NCT00083382 CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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