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Early response predicts thalidomide efficiency in patients with advanced multiple myeloma

Waage, A; Gimsing, P; Juliusson, G; Turesson, Ingemar LU ; Gulbrandsen, N; Eriksson, Tommy LU ; Hjorth, M; Nielsen, JL; Lenhoff, S and Westin, Jan LU , et al. (2004) In British Journal of Haematology 125(2). p.149-155
Abstract
Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders... (More)
Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders (70%) after 3 weeks, and in 20 of 22 responders (91%) after 5 weeks of treatment. Reduction of M protein continued for 3 months and further decline was observed in only four patients. The Hb concentration showed a different time course, with a significant increase after 3 months and further increases continued for up to 12 months. Blood concentration levels of thalidomide from 40 patients were used to evaluate the pharmacokinetics of the drug. Rate of absorption, rate of elimination, volume of distribution, clearance and elimination half-life were calculated to be 0.200/h, 0.140/h, 0.886 l/kg, 0.126 l/h/kg and 4.98 h respectively. We found no relationship between thalidomide concentration and effect after 12 weeks. (Less)
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Contribution to journal
publication status
published
subject
keywords
quality of life, pharmacokinetics, early response, multiple myeloma, thalidomide
in
British Journal of Haematology
volume
125
issue
2
pages
149 - 155
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • pmid:15059136
  • wos:000221169900005
  • scopus:11144354538
ISSN
0007-1048
DOI
10.1111/j.1365-2141.2004.04879.x
language
English
LU publication?
yes
id
bc55a1ec-22fd-4e19-824a-0893670179b7 (old id 279965)
date added to LUP
2007-11-05 07:29:47
date last changed
2017-07-02 03:36:05
@article{bc55a1ec-22fd-4e19-824a-0893670179b7,
  abstract     = {Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders (70%) after 3 weeks, and in 20 of 22 responders (91%) after 5 weeks of treatment. Reduction of M protein continued for 3 months and further decline was observed in only four patients. The Hb concentration showed a different time course, with a significant increase after 3 months and further increases continued for up to 12 months. Blood concentration levels of thalidomide from 40 patients were used to evaluate the pharmacokinetics of the drug. Rate of absorption, rate of elimination, volume of distribution, clearance and elimination half-life were calculated to be 0.200/h, 0.140/h, 0.886 l/kg, 0.126 l/h/kg and 4.98 h respectively. We found no relationship between thalidomide concentration and effect after 12 weeks.},
  author       = {Waage, A and Gimsing, P and Juliusson, G and Turesson, Ingemar and Gulbrandsen, N and Eriksson, Tommy and Hjorth, M and Nielsen, JL and Lenhoff, S and Westin, Jan and Wisloff, F},
  issn         = {0007-1048},
  keyword      = {quality of life,pharmacokinetics,early response,multiple myeloma,thalidomide},
  language     = {eng},
  number       = {2},
  pages        = {149--155},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {Early response predicts thalidomide efficiency in patients with advanced multiple myeloma},
  url          = {http://dx.doi.org/10.1111/j.1365-2141.2004.04879.x},
  volume       = {125},
  year         = {2004},
}