Clinical analysis of 110 patients with multiple myeloma treated with thalidomide included regimens

C Objective To explore the response rate （RR）,progress free survival （PFS） and overall survival （OS） in Chinese patients with multiple myeloma （MM） treated with thalidomide （Thal） included regimens and identify the potential prognostic factors. Methods Our study enrolled 110 patients treated with Thai included regimens and their laboratory and clinical parameters were retrospectively analyzed. Comparisons of RR were performed by x^2 test. Survival analysis was performed by Kaplan-Meier method and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model. Results The patients received either Thai alone （5 patients）, Thai plus dexamethasone （Thal＋Dex） （55 patients） or Thai plus conventional chemotherapy （Thai＋CC） （50 patients）. The overall RR was 63. 6%（complete response rate 6. 4%,partial response rate 57. 3%）. Patients with age 〈65 years,time from diagnosis to the start of Thai treatment 〈6 months or combined therapy had a significantly higher RR（P〈0.05）. In univariate analysis,age 〈65 years predicted a longer PFS（P=0.008）. Age 〈65 years,serum creatinine（Cr） 〈176.8μmol/L and serum beta 2 microglobulin （132 MG） 〈3. 5 mg/L were associated with longer OS（P=0. 028,0. 045 and 0. 019,respectively）. Multifactor analysis suggested that serum β2MG was the only independent prognostic factor for OS（P= 0. 025）. Most common side effects consisted of constipation（38.2% ）,somnolence （33.6%）,edema（31.8% ） and numbness（29%）,which was tolerated by majority of the patients. Rare but severe adverse events included bradycardia（2. 7%）,thromboembolism（1.8%） and mental anomaly（0. 9%）. Conclusion Thai included therapy proved to have confirmed efficacy for the treatment of myeloma with tolerable side effects by most patients. The RR was associated with age,time of the start of thalidomide therapy and treatment regimens. Age was also a prognostic factor for PFS. Serum β2 MG was an independent prognostic factor for OS. Key words: Multiple myeloma;  Thalidomide;  Efficacy;  Prognosis