Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma.
The present study aimed to evaluate the side-effects and efficacy of thalidomide in combination with an anthracycline-containing chemotherapy regimen in previously untreated myeloma patients. Thalidomide (400 mg/d) was combined with bolus injections of vincristine and epirubicin and oral dexamethaso...
| Автори: | , , , , , , , , , , , , |
|---|---|
| Формат: | Journal article |
| Мова: | English |
| Опубліковано: |
2005
|
| _version_ | 1826295194899709952 |
|---|---|
| author | Schütt, P Ebeling, P Buttkereit, U Brandhorst, D Opalka, B Hoiczyk, M Flasshove, M Hense, J Bojko, P Metz, K Moritz, T Seeber, S Nowrousian, MR |
| author_facet | Schütt, P Ebeling, P Buttkereit, U Brandhorst, D Opalka, B Hoiczyk, M Flasshove, M Hense, J Bojko, P Metz, K Moritz, T Seeber, S Nowrousian, MR |
| author_sort | Schütt, P |
| collection | OXFORD |
| description | The present study aimed to evaluate the side-effects and efficacy of thalidomide in combination with an anthracycline-containing chemotherapy regimen in previously untreated myeloma patients. Thalidomide (400 mg/d) was combined with bolus injections of vincristine and epirubicin and oral dexamethasone (VED). Chemotherapy cycles were repeated every 3 wk until no further reduction in myeloma protein was observed, whereas the treatment with thalidomide was continued until disease progression. Thirty-one patients were enrolled, 12 patients were exclusively treated with thalidomide in combination with VED and 19 patients additionally received high-dose melphalan, for consolidation. Adverse events and response to therapy were assessed prior to treatment with high-dose chemotherapy. Response to thalidomide combined with VED was complete remission in six patients (19%), partial remission in 19 patients (61%), stable disease in five patients (16%), and progressive disease in one patient (3.2%). Grade 3 and 4 adverse events consisted of leukocytopenia in 10 patients (32%), and thrombocytopenia and anemia in one patient each (3.2%). Neutropenic infections grade 3 and 4 occurred in seven (23%) and three patients (9.7%), respectively, including two patients (6.5%) who died from septic shock. Deep vein thrombosis occurred in eight patients (26%), constipation in 20 patients (65%), and polyneuropathy in 20 patients (65%). The probability of event-free survival and overall survival in the whole group of patients at 36 months were 26 and 62%, respectively. In conclusion, the combination of thalidomide with VED appears to be highly effective in previously untreated patients with multiple myeloma, but it is associated with a high rate of thrombotic events, polyneuropathy, and neutropenic infections. |
| first_indexed | 2024-03-07T03:57:18Z |
| format | Journal article |
| id | oxford-uuid:c3502f6e-a9b2-41d5-b6a5-f2d39965816f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:57:18Z |
| publishDate | 2005 |
| record_format | dspace |
| spelling | oxford-uuid:c3502f6e-a9b2-41d5-b6a5-f2d39965816f2022-03-27T06:15:31ZThalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c3502f6e-a9b2-41d5-b6a5-f2d39965816fEnglishSymplectic Elements at Oxford2005Schütt, PEbeling, PButtkereit, UBrandhorst, DOpalka, BHoiczyk, MFlasshove, MHense, JBojko, PMetz, KMoritz, TSeeber, SNowrousian, MRThe present study aimed to evaluate the side-effects and efficacy of thalidomide in combination with an anthracycline-containing chemotherapy regimen in previously untreated myeloma patients. Thalidomide (400 mg/d) was combined with bolus injections of vincristine and epirubicin and oral dexamethasone (VED). Chemotherapy cycles were repeated every 3 wk until no further reduction in myeloma protein was observed, whereas the treatment with thalidomide was continued until disease progression. Thirty-one patients were enrolled, 12 patients were exclusively treated with thalidomide in combination with VED and 19 patients additionally received high-dose melphalan, for consolidation. Adverse events and response to therapy were assessed prior to treatment with high-dose chemotherapy. Response to thalidomide combined with VED was complete remission in six patients (19%), partial remission in 19 patients (61%), stable disease in five patients (16%), and progressive disease in one patient (3.2%). Grade 3 and 4 adverse events consisted of leukocytopenia in 10 patients (32%), and thrombocytopenia and anemia in one patient each (3.2%). Neutropenic infections grade 3 and 4 occurred in seven (23%) and three patients (9.7%), respectively, including two patients (6.5%) who died from septic shock. Deep vein thrombosis occurred in eight patients (26%), constipation in 20 patients (65%), and polyneuropathy in 20 patients (65%). The probability of event-free survival and overall survival in the whole group of patients at 36 months were 26 and 62%, respectively. In conclusion, the combination of thalidomide with VED appears to be highly effective in previously untreated patients with multiple myeloma, but it is associated with a high rate of thrombotic events, polyneuropathy, and neutropenic infections. |
| spellingShingle | Schütt, P Ebeling, P Buttkereit, U Brandhorst, D Opalka, B Hoiczyk, M Flasshove, M Hense, J Bojko, P Metz, K Moritz, T Seeber, S Nowrousian, MR Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title | Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title_full | Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title_fullStr | Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title_full_unstemmed | Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title_short | Thalidomide in combination with vincristine, epirubicin and dexamethasone (VED) for previously untreated patients with multiple myeloma. |
| title_sort | thalidomide in combination with vincristine epirubicin and dexamethasone ved for previously untreated patients with multiple myeloma |
| work_keys_str_mv | AT schuttp thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT ebelingp thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT buttkereitu thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT brandhorstd thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT opalkab thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT hoiczykm thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT flasshovem thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT hensej thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT bojkop thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT metzk thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT moritzt thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT seebers thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma AT nowrousianmr thalidomideincombinationwithvincristineepirubicinanddexamethasonevedforpreviouslyuntreatedpatientswithmultiplemyeloma |