Thalidomide improves remission in myeloma

Myeloma is one of the least curable cancers and involves plasma cells, the white blood cells that produce antibodies.

When plasma cells become cancerous, they reproduce uncontrollably and crowd out healthy red and white blood cells, preventing them from fighting infection and carrying oxygen throughout the body.

Bone destruction is a common manifestation of myeloma and the malignant cells also produce a type of protein that can cause kidney failure.

In the past the average survival rate of a myeloma patient was around three years following diagnosis, now due to research the average survival rate of its patients to seven years and beyond.

A long-term study by a team from the University of Arkansas for Medical Sciences, examined the effectiveness of the drug Thalidomide as part of the treatment for multiple myeloma.

The researchers led by myeloma expert Bart Barlogie, M.D., Ph.D. found the drug improved remission rates in patients.

The results arose from the addition of thalidomide to a myeloma treatment regimen that included high-dose, melphalan-based chemotherapy in a setting of tandem peripheral blood stem-cell transplants.

In the trial, involving 668 myeloma patients between October 1998 and February 2004, those who received thalidomide as part of their treatment had a higher complete remission rate and a superior event-free, five-year survival rate (meaning there were no signs of relapse in that time period) than those in a control group.

However, thalidomide failed to prolong overall survival and was associated with adverse side effects, including damage to the peripheral nervous system, and deep-vein thrombosis.

Barlogie, the lead researcher for the study, has pioneered the use of thalidomide as a therapeutic agent in treating multiple myeloma.

Thalidomide was tried initially in the case of unresponsive disease because it interferes with the blood supply to the tumor cells and kills them through an indirect mechanism.

Further research has shown that thalidomide has many potentially beneficial anti-tumor effects, says Barlogie, including direct tumor cell destruction and interruption of tumor-host cell interaction.


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