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Thalidomide dosing in patients with relapsed or refractory multiple myeloma
Jennifer L Thompson1, Lea Ann Hansen
1School of Pharmacy, Virginia Commonwealth University Health System/Medical College of Virginia Hospitals and Physicians, Richmond, VA 23298, USA.
The Annals of Pharmacotherapy
|March 28, 2003
Summary
This study reviews thalidomide dosing for multiple myeloma patients. Optimal dosing involves starting at 50-100 mg nightly, escalating to 400-600 mg/d for better outcomes, and assessing efficacy at 8 weeks.
Area of Science:
- Hematology
- Clinical Pharmacology
Background:
- Multiple myeloma patients often have limited treatment options.
- Thalidomide shows promise as a therapeutic agent.
Purpose of the Study:
- To review existing literature on thalidomide dosing strategies for multiple myeloma.
Main Methods:
- Conducted a MEDLINE search from 1990 to February 2003.
- Included clinical trials and abstracts, cross-referencing for additional data.
Main Results:
- Initial thalidomide doses ranged from 50-200 mg/d, typically at bedtime.
- Dose escalation up to 800 mg/d was studied.
- Doses of 400-600 mg/d showed improved outcomes, with better tolerance at <=400 mg/d.
Conclusions:
- Initiate thalidomide at 50-100 mg nightly, escalating by 50-100 mg every 2 weeks.
- Titrate dose to 400-600 mg/d, particularly for poor-prognosis patients.
- Assess efficacy at 8 weeks and maintain dose if response is achieved.