Treatment of Waldenstrom's macroglobulinemia with single-agent thalidomide or with the combination of clarithromycin, thalidomide and dexamethasone

被引:42
作者
Dimopoulos, MA
Tsatalas, C
Zomas, A
Hamilos, G
Panayiotidis, P
Margaritis, D
Matsouka, C
Economopoulos, T
Anagnostopoulos, N
机构
[1] Univ Athens, Sch Med, Dept Clin Therapeut, GR-11527 Athens, Greece
[2] Univ Athens, Sch Med, Dept Internal Med, GR-11527 Athens, Greece
[3] Dimokrit Univ Thrace, Dept Hematol, Alexandroupolis, Greece
[4] Genimatas Gen Hosp, Dept Hematol, Athens, Greece
关键词
D O I
10.1053/sonc.2003.50079
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To evaluate the activity of thalidomide in Waldenstrom's macroglobulinemia (WM), 20 patients were treated on a dose schedule that escalated from 200 mg/d to 600 mg/d. On an intention-to-treat basis, five (25%) patients achieved a partial response, which was noted within 3 months of treatment. Adverse effects were common and prevented dose escalation of thalidomide in 75% of patients and led to premature discontinuation of treatment in 35%. We subsequently evaluated the oral combination of clarithromycin (500 mg twice per day), low-dose thalidomide (200 mg once daily), and dexamethasone (40 mg once per week). Our preliminary analysis on 12 previously treated patients indicate activity of this regimen in WM: three patients achieved a partial response and two patients demonstrated monoclonal protein reduction of greater than 25%. This combination was associated with a variety of side effects due not only to thalidomide, but also to corticosteroids and to clarithromycin. Our preliminary data indicate that this combination may be a useful salvage regimen for some patients with heavily pretreated macroglobulinemia. © 2003 Elsevier Inc. All rights reserved.
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页码:265 / 269
页数:5
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