Induction therapy and thalidomide based maintenance in multiple myeloma – A retrospective analysis from a tertiary cancer center
Abstract
Objective: To analyse the treatment results and maintenance with Thalidomide in multiple myeloma (MM)
patients who are not eligible for transplant. Methods: Retrospective analysis of 41 multiple myeloma
patients (Jan 2012-Dec 2015) treated with either BDT regimen (Bortezomib, Dexamethasone, Thalidomide) or CVP-T regimen (cyclophosphamide, Vincristine, Prednisolone plus thalidomide) followed by Thalidomide based maintenance was done. Thalidomide maintenance was given for 2 years. Adverse effects were also analysed. Results: Out of 28 patients treated with BDT regimen, 15(54%) patients achieved complete remission (CR), 5(18%) achieved very good partial response (VGPR) & 8(28%) had partial remission (PR). Out of 13 patients (32%) treated with CVP-T regimen, 4(31%) achieved CR, 3(22%) achieved VGPR, 5(37%) had PR. At 36 months, 7 patients (24%) after BDT regimen followed by thalidomide and dexamethasone maintenance and 1 patient (9%) after CVP-T regimen followed by oral cyclophosphamide and thalidomide were progression free. Totally 8 out of 41(20%) with thalidomide based maintenance were progression free at 36 months. Grade 2 Neuropathy in 11 and Grade 3 Neuropathy in 6 patients was observed when maintenance therapy was given for 2 years. Also 3 had Deep vein Thrombosis. Conclusion: Induction with BDT regimen results in 54% CR whereas CVP-T regimen results in 31% CR. 20% were progression free at 36 months with Thalidomide based maintenance after BDT and CVP-T regimen. Thalidomide based maintenance is a valid option after induction chemotherapy where stem cell transplant is not considered an option.
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