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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2001 > August

Thalidomide active against Waldenström's macroglobulinemia

Last Updated: 2001-08-24 11:23:26 EDT (Reuters Health) - Some patients with Waldenström's macroglobulinemia (WM) respond to thalidomide therapy, according to the results of a phase II trial conducted by Greek researchers.

Dr. Meletios A. Dimopoulos, from the University of Athens School of Medicine, and colleagues treated 11 men and 9 women with WM, 48 to 85 years of age, with thalidomide starting at a dose of 200 mg daily. Every 14 days the dose was increased by 200 mg, as tolerated, to a maximum dose of 600 mg daily, according to the team's report in the August 15th issue of the Journal of Clinical Oncology.

During the 10-month trial, five female patients achieved a partial response, the researchers report. In an additional five patients, the disease stabilized, with a subsequent median time to progression of 4 months. The remaining 10 patients experienced early disease progression.

"None of the patients treated during refractory relapse or with disease duration exceeding 2 years responded to thalidomide," according to the report.

All patients experienced some adverse effects, including constipation, somnolence and fatigue, and about one third of the patients developed mood changes, depression and tremor.

Only five patients were able to tolerate doses of 600 mg per day. Nine patients did not reach the maximum dose due to intolerance and six patients did not reach it due to progressive disease, Dr. Dimopoulos's team notes.

"Thalidomide has emerged as an effective agent in the treatment of relapsed myeloma. It seems to have activity in Waldenström's macroglobulinemia and merits further study," Dr. S. Vincent Rajkumar and Dr. Robert A. Kyle, from the Mayo Clinic in Rochester, Minnesota, comment in a journal editorial.

"Patients and physicians must continue to exercise caution when using thalidomide to avoid teratogenic complications," Drs. Rajkumar and Kyle add.

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