Thrombosis Is Uncommon in Chinese Patients Receiving Thalidomide- Experience in a Regional Hospital in Hong Kong.

OBJECTIVE: To determine the incidence of venous thromboembolism and other side effects of thalidomide in Chinese population Setting: Queen Elizabeth Hospital, Hong Kong SAR. Subjects and Methods: Patients who had received thalidomide from 2001 to 2005 were evaluated in this retrospective study. Thalidomide was given either as a single agent at a dose of 100–400mg/day (median dose: 200mg; mean dose: 257.3mg) or in a combination with dexamethasone at a dose of 20– 40mg (oral) on days 1–4. A minimum of 4 weeks of duration of thalidomide was recruited for assessment. Toxicities were graded according to WHO criteria. Results: Of the 55 patients recruited, 41 patients were evaluable for assessing side effects. The diagnosis of our patients included myelodysplastic syndrome (1/41, 2.4%) refractory mantle cell lymphoma (1/41, 2.4%); myelofibrosis (6/41, 14.6%); and multiple myeloma (33/41, 80.5%). Nine (22%) patients received thalidomide as first line therapy. Thirty-two (78%) patients received thalidomide as 2nd line therapy. Thirty-four (82.9%) patients used thalidomide as single agent. Seven (17.1%) patients used thalidomide as combination therapy. Duration of thalidomide treatment ranged from 4 weeks to 219.3 weeks (Mean 29.4 weeks, median: 20 weeks ). The most commonly observed toxicities were constipation (51.2%), somolence (24.4%), peripheral neuropathy (22%). Only one (2.4%) patient who suffered from myeloma complicated by Miller Fisher syndrome and tetraplegia developed deep vein thrombosis after 4 weeks treatment with thalidomide (300mg/day) plus oral dexamethasone. Conclusion: Chinese patients in our center tolerated thalidomide well. The low incidence of venous thrombosis observed suggests that anticoagulant prophylaxis may not be warranted in Chinese patiens.