Toxicity profile of thal-dex regime in patients with multiple myeloma
Keywords:Dexamethasone, Multiple myeloma, Thal-Dex toxicity, Thalidomide
Background: To study the spectrum, incidence and severity of toxicity among Multiple Myeloma patients receiving Thal-Dex in South Indian population.
Methods: Between November 2005 and November 2005, 25 adult patients with previously- untreated Multiple Myeloma were assigned to receive Thal-Dex at Regional Cancer Centre, Trivandrum. During chemotherapy, patients were followed-up to detect the development of any toxicity symptoms. The toxicities recorded, were graded according to the criteria of the World Health Organization toxicity-guidelines.
Results: In the 25 patients who received Thal-Dex, peripheral neuropathy, infection and constipation were significantly seen, while gastrointestinal toxicities were seen to a lesser extent, and haematological toxicities were low.
Conclusions: The Thal-Dex regimen was tolerated well by majority of the patients and showed favourable toxicity profile, reiterating its acceptability as a front line antimyeloma regimen
Robert A. Vesico, James R Bernson. Myeloma, Macroglobulinemia and amyloidosis- Cancer treatment-Haskell 5th edition. 1999:1503-1539.
Gareth Morgan and Peter Selby-Myeloma-Oxford Textbook of Oncology, 2nd edition; 15-12:2419-55.
Vincent T, Divetta, Samuel Hellman, Steva A. Rosenberg. Antiangiogenesis agents: Cancer Principles and Practice of Oncology. 6th edition; 63:2765-70.
Singhal S, Metha J, Desikan R. Antitumor activity of Thalidomide in refractory Multiple Myeloma. NEJM. 1999;341:1565-71.
Attal M, Harousseau JL, Stoppa AM. A prospective randomized trial of autologous bone marrow transplantation and chemotherapy in Multiple Myeloma. NEJM. 1996;336:91-7.
Bardos A, Barlogie B, Siegel E. Autologous stem cell transplantation in elderly multiple myeloma patients over the age of 70 years. Br J Haematol. 2001;114:600-7.
Hussien MA, Wood L, Hsi E. Phase II trial of pegylated liposomal doxorubicin, Vincristine, and reduced-dose Dexamethasone combination therapy in newly diagnosed myeloma patients. Cancer. 2002;95:2160-8.
Richardson P, Anderson. Thalidomide K. Dexamethasone: A new standard of care for initial therapy in multiple myeloma. J Clin Oncol. 2006;132:155-67.
Rajkumar SV, Blood E, Vesole D. Eastern Cooperative Oncology Group. J Clin Oncol. 2006;24:31-6.
Weber D, Rankin K, Ga M. Thalidomide alone or with Dexamethasone for previously untreated multiple myeloma. J Clin Oncol. 2003;21:16-9.
Cavo M, Zamagni E, Tosi P. Superiority of Thalidomide and Dexamethasone over VAD as primary therapy in preparation for autologous transplantation for multiple myeloma. Blood 2005:106:35-39.
Dimopoulos MA, Eleutherkis V. Adverse effects of thalidomide administration in patients neoplastic diseases. Am J Med. 2004;117:508-15.
Badrose AZ, Siegal E, Bodenner D. Hypothyroidism in patients with multiple myeloma following treatment with thalidomide. Am J Med. 2002;112:412-3.
Rajkumar. Blood AHS; Annual meeting. Abstract-2004;104:205.