Doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective well tolerated initial therapy for multiple myeloma Journal Article

Authors: Hassoun, H.; Reich, L.; Klimek, V. M.; Dhodapkar, M.; Cohen, A.; Kewalramani, T.; Zimman, R.; Drake, L.; Riedel, E. R.; Hedvat, C. V.; Teruya-Feldstein, J.; Filippa, D. A.; Fleisher, M.; Nimer, S. D.; Comenzo, R. L.
Article Title: Doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective well tolerated initial therapy for multiple myeloma
Abstract: Among the drug combinations designed for the initial treatment of multiple myeloma, none has been unequivocally shown to be superior. However, a regimen leading to a high response rate and a low incidence of adverse events is highly desirable. We report the results of a phase II clinical trial involving 45 patients with Durie-Salmon stage II and III multiple myeloma. Doxorubicin and dexamethasone were given for 2 or 3 months followed by thalidomide and dexamethasone for 2 months (AD-TD regimen) with prophylactic antibiotics and daily aspirin (81 mg/d). Among the 42 patients whose response could be assessed, 38 responded to therapy (90.5%). The intent-to-treat response rate was 84.4% with seven complete responses (CR 15.5%), nine near complete responses (nCR 20.0%), and 22 partial responses (PR 48.9%). Two patients had stable disease (4.4%), and two progression of disease (4.4%). Normalization of the free light chain ratio after one or two cycles of treatment was highly predictive of achievement of CR or nCR. Patients tolerated the treatment well although five patients developed thromboembolic complications (11%). AD-TD administered with low dose aspirin for deep vein thrombosis prophylaxis was well tolerated and yielded a high response rate with minimal treatment-related morbidity. © 2005 Blackwell Publishing Ltd.
Keywords: adult; clinical article; controlled study; treatment response; aged; antibiotic agent; thalidomide; clinical trial; constipation; disease course; drug tolerability; neutropenia; doxorubicin; cancer combination chemotherapy; hypophosphatemia; side effect; neurotoxicity; outcome assessment; edema; low drug dose; controlled clinical trial; drug eruption; infection; multiple myeloma; phase 2 clinical trial; anemia; nausea; thrombocytopenia; dehydration; peripheral neuropathy; morbidity; dexamethasone; deep vein thrombosis; drug effect; prediction; hyperglycemia; lymphocytopenia; lung embolism; chemotherapy induced emesis; confusion; gastrointestinal toxicity; hyponatremia; cancer regression; acetylsalicylic acid; thromboembolism; prophylaxis; cotrimoxazole; antibiotic prophylaxis; ataxia; fluconazole; vitamin b complex; omeprazole; phlebitis; weight gain; bloating; mood change; free light chain
Journal Title: British Journal of Haematology
Volume: 132
Issue: 2
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2006-01-01
Start Page: 155
End Page: 161
Language: English
DOI: 10.1111/j.1365-2141.2005.05848.x
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 29" - "Export Date: 4 June 2012" - "CODEN: BJHEA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Virginia Klimek
    122 Klimek
  2. Cyrus Hedvat
    125 Hedvat
  3. Julie T Feldstein
    290 Feldstein
  4. Adam D Cohen
    43 Cohen
  5. Raymond L Comenzo
    114 Comenzo
  6. Hani Hassoun
    168 Hassoun
  7. Stephen D Nimer
    347 Nimer
  8. Martin Fleisher
    278 Fleisher
  9. Lilian M Reich
    91 Reich
  10. Daniel A Filippa
    128 Filippa
  11. Rachel Zimman
    2 Zimman
  12. Lisa A Drake
    9 Drake