Related Experiment Video

Updated: Sep 28, 2026

Chemical Inactivation of the E3 Ubiquitin Ligase Cereblon by Pomalidomide-based Homo-PROTACs
10:44

Chemical Inactivation of the E3 Ubiquitin Ligase Cereblon by Pomalidomide-based Homo-PROTACs

Published on: May 15, 2019

The adverse effects of thalidomide in relapsed and refractory patients of multiple myeloma

J K Grover1, G Uppal, V Raina

  • 1Department of Pharmacology, All India Institute of Medical Sciences, New Delhi. jkgrover@hotmail.com

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|October 16, 2002
PubMed

Insights

Thalidomide is effective for multiple myeloma (MM) patients. Adverse effects like constipation and sedation are common but manageable, with peripheral neuropathy appearing late and rarely in Indian patients.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Multiple myeloma (MM) is a hematologic malignancy.
  • Relapsed or refractory MM patients often require novel therapeutic strategies.
  • Thalidomide has demonstrated efficacy in MM treatment.

Observation:

  • A study observed the adverse effect profile of thalidomide in 23 relapsed/refractory MM patients over 15 months.
  • Data on incidence, onset, and tolerance of adverse drug reactions were collected.
  • Specific attention was paid to peripheral neuropathy and its characteristics in Indian patients.

Findings:

  • Constipation (100%) and sedation (87%) were the most frequent adverse effects.
  • Peripheral neuropathy was late-onset (>12 months) and had a low incidence.
  • Tolerance developed to sedation and constipation; peripheral neuropathy was the main reason for dose reduction or discontinuation.
  • Indian patients developed peripheral neuropathy at higher cumulative doses (>200g) and longer duration (>10 months) compared to Western reports.

Implications:

  • Thalidomide is a relatively safe and tolerable option for prolonged treatment of relapsed/refractory MM.
  • Understanding the specific adverse event profile, particularly peripheral neuropathy, in different ethnic populations is crucial for optimizing MM therapy.
  • Further research into managing thalidomide-induced toxicities may enhance its clinical utility.

Related Concept Videos

Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...