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Intermediate dose thalidomide (200 mg daily) has comparable efficacy and less toxicity than higher doses in relapsed
A D Wechalekar1, C I Chen, D Sutton
1Dept of Hematology/Oncology, University of Toronto, Princess Margaret Hospital, Toronto, Ont., Canada. ashutoshw@hotmail.com
Abstract:
Thalidomide at doses >200 mg has 100% grade 1-2 and 25% grade 3-4 toxicities requiring discontinuation. We report a retrospective study of relapsed myeloma patients treated with thalidomide 200 mg with no dose escalation. Thirty patients were identified; 43% of patients responded with paraprotein decline >75% -- 2 (6%), 50-75% -- 7 (23%), 25-50% -- 4 (14%) and 2 (6%) were stable. All five patients with 13q deletion responded. Only 54% reported grade 1-2 toxicities (none reporting > grade 2) with 5 (17%) discontinuing treatment due to toxicity. Thalidomide 200 mg daily with no dose escalation appears as effective and better tolerated than escalated doses for relapsed myeloma patients.