Conflict of interest: M.A.G has received honoraria from Celgene, Millenium, Genzyme, and Amgen, S.K. has a consultant/advisory relationship and has received research support from Celgene, M.Q.L., A.D., T.E.W, have received research funding/grants from Celgene, J. L. consultancy for Celgene, R.A.K. has received honoraria from Celgene, P.R.G. has received honoraria from Celgene and Amgen. The remaining authors declare no conflict of interest.
Long-term results of single-agent thalidomide as initial therapy for asymptomatic (smoldering or indolent) myeloma†
Article first published online: 8 JUL 2010
Copyright © 2010 Wiley-Liss, Inc.
American Journal of Hematology
Volume 85, Issue 10, pages 737–740, October 2010
How to Cite
Detweiler-Short, K., Hayman, S., Gertz, M. A., Lacy, M. Q., Dispenzieri, A., Kumar, S., Zeldenrust, S. R., Russell, S. J., Lust, J. A., Kyle, R. A., Greipp, P. R., Witzig, T. E. and Vincent Rajkumar, S. (2010), Long-term results of single-agent thalidomide as initial therapy for asymptomatic (smoldering or indolent) myeloma. Am. J. Hematol., 85: 737–740. doi: 10.1002/ajh.21821
- Issue published online: 8 JUL 2010
- Article first published online: 8 JUL 2010
- Manuscript Accepted: 2 JUL 2010
- Manuscript Received: 30 JUN 2010
- National Cancer Institute, National Institutes of Health, Bethesda, MD. Grant Numbers: CA62242, CA107476
We report the long-term follow-up results of a phase II trial of thalidomide for early-stage multiple myeloma (MM). Patients were eligible if they had smoldering multiple myeloma (SMM) or indolent MM without the need for immediate therapy. Thalidomide was initiated at a dose of 200 mg/day and adjusted as tolerated. Disease progression was defined using modified American Society of Hematology/Food and Drug Administration consensus panel criteria for SMM. Thirty-one patients were enrolled; 29 (19 SMM and 10 indolent MM) were eligible. The median age was 61 years. Median follow-up of living patients was 10.2 years (range, 7.5-11.0 years). Ten patients (34%) had a partial response (PR) and nine had minimal response (MR) for an MR plus PR rate of 66%. The median time to progression (TTP) to symptomatic myeloma was 35 months. Median TTP was 61 months in those achieving PR, 39 months with MR, and 9 months among those failing to achieve either MR or PR, P = 0.005. Median overall survival from diagnosis was 86 months; median survival from onset of symptomatic myeloma was 49 months. Grade 3-4 nonhematologic adverse events were noted in 55% of patients. Randomized trials are needed to determine the role of early therapy in SMM. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc.