Intermediate Dose Thalidomide (200 mg Daily) has Comparable Efficacy and Less Toxicity than Higher Doses in Relapsed Multiple Myeloma

Abstract

Thalidomide at doses >200 mg has 100% grade 1–2 and 25% grade 3–4 toxicities requiring discontinuation. We report a retrospective study of relapsed myeloma patients treated with thalidomide 200 mg with no dose escalation. Thirty patients were identified; 43% of patients responded with paraprotein decline >75%-2 (6%), 50–75%-7 (23%), 25–50%-4 (14%) and 2 (6%) were stable. All five patients with 13q deletion responded. Only 54% reported grade 1–2 toxicities (none reporting > grade 2) with 5 (17%) discontinuing treatment due to toxicity. Thalidomide 200 mg daily with no dose escalation appears as effective and better tolerated than escalated doses for relapsed myeloma patients.

• Thalidomide
• Intermediate dose
• Dose escalation
• Efficacy