CTD regimen (cyclophosphamide, thalidomide, dexamethasone) in the treatment of relapsed or refractory multiple myeloma


Authors: M. Zemanová 1;  V. Ščudla 1;  L. Pour 2;  E. Gregora 3;  P. Pavlíček 3;  J. Minařík 1;  T. Pika 1;  J. Bačovský 1;  Z. Adam 2;  R. Hájek 2
Authors‘ workplace: pro Českou myelomovou skupinu ;  III. interní klinika LF UP a FN Olomouc, 2Interní hematoonkologická klinika FN Brno- Bohunice a LF MU v Brně, 3Odd. klinické hematologie FNKV Praha 1
Published in: Transfuze Hematol. dnes,13, 2007, No. 3, p. 126-132.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Besides conventional chemotherapy, several new drugs are used in multiple myeloma treatment. Thalidomide is one of the most used. The combination of low-dosed thalidomide with cyclophosphamide and dexamethasone has shown very good results. The aim of this study is to verify the effect and to assess the toxicity of the „CTD-junior“ regimen, for patients up to 65 years, with pulsed intravenous application of cyclophosphamide at the dose of 800 mg on day 1 once a 21-days’ interval, thalidomide 200 mg daily and oral dexamethasone 40 mg on days 1–4 and 12–15, and the „CTD-senior“ regimen, for patients over 65 years, with continuous use of oral cyclophosphamide 50 mg daily, thalidomide 100 mg daily and oral dexamethasone 20 mg on days 1–4 and 15–18, in a 28-days’ cycle. From the group of 97 patients with progressive form of multiple myeloma or with resistance to conventional chemotherapy, 85 patients were evaluated. Objective response was reached in 68 (80%) patients, from which complete remission was reached in 7 (8 %), partial remission in 42 (50%) and minimal response in 19 (22 %) patients. The disease was stabilized in 10 (12%) patients, while 7 (8%) patients progressed. It was showed, that the toxicity of both regimens was quite low and easily affected, when weakness, obstipation, neuropathy of lower extremities, glycoregulation worsening and mild leucopenia occured most often. From the study results, that the use of thalidomide in both performed regimens widens the therapeutic possibilities in patients with multiple myeloma resistant to conventional chemotherapy, and that both regimens are very good for use in common hematology practise.

Key words:
multiple myeloma, resistance to therapy, thalidomide, cyclophosphamide, dexamethasone


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Labels
Haematology Internal medicine Clinical oncology

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