The efficacy of the CTD regimen (cyclophosphamide, thalidomide, dexamethasone) in therapy of relapsed and 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; Pro Českou Myelomovou Skupinu
Authors‘ workplace:
III. interní klinika LF UP a FN Olomouc, 2Interní hematoonkologická klinika FN Brno-Bohunice
a LF MU v Brně, 3Oddělení klinické hematologie FN KV Praha
1
Published in:
Transfuze Hematol. dnes,16, 2010, No. 3, p. 126-132.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
Thalidomide has been estimated as a useful drug in the treatment of multiple myeloma in monotherapy or in combinations with steroids and alkylating drugs. The combination of low-dose thalidomide with cyclophosphamide and dexamethasone has shown very good results. In the actual study, authors present the effect, toxicity and results of long-time follow-up of patients treated by the combination of thalidomide, cyclophosphamide and dexamethasone in the „CDT-junior“ regimen for patients up to 65 years (cyclophosphamide 800 mg intravenously on day 1 once a 21-daysę interval, thalidomide 200 mg orally daily and dexamethasone 40 mg orally on days 1–4 and 12–15), and in the „CTD-senior“ regimen for patients over 65 years (cyclophosphamide 50 mg orally daily, thalidomide 100 mg orally daily and dexamethasone 20 mg orally on days 1–4 and 15–18, in a 28-daysę cycle). From the group of 126 patients with progressive form of multiple myeloma or with resistance to conventional chemotherapy, 109 patients were evaluated. Using both modalities of the CTD regimen, objective response was reached in 78 (71.6%) patients, of them complete remission was achieved in 17 (15.6%), very good partial remission in 5 (4.6%) and partial remission in 56 (51.4%) patients. Disease was stabilized in 21 (19.2%) patients, while 10 (9.2%) patients progressed. The toxicity of both regimens was quite low and can be easily managed; weakness, obstipation, neuropathy of lower extremities, glycoregulation worsening and mild leucopenia occured most often. Median of overall survival from the start of the CTD treatment was in the whole group 31.5 months and median of time to progression was 15 months. The difference between „junior“ and „senior“ regimens was not statistically significant. It can be concluded, that the use of thalidomide in both discussed regimens has broaden the therapeutic possibilities in patients with multiple myeloma resistant to conventional chemotherapy.
Key words:
multiple myeloma, resistance to therapy, thalidomide, cyclophosphamide, dexamethasone
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Labels
Haematology Internal medicine Clinical oncologyArticle was published in
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