The combination of melphalan, prednisone, and thalidomide produced a quick and lasting response in newly diagnosed multiple myeloma patients, according to a study published in the journal Cancer .
Multiple myeloma is a cancer of the blood that affects the plasma cells. Plasma cells are an important part of the immune system and produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells, which can result in symptoms such as increased risk for bacterial infections or impaired immune responses. Other effects of myeloma may include damage to the kidneys, osteoporosis, anemia, and an elevated blood calcium level. New treatment approaches for multiple myeloma continue to be evaluated; they frequently involve new combinations of drugs.
The drug combination melphalan and prednisone and the drug thalidomide are established treatment options for multiple myeloma. The effect, however, of combining these three drugs is unknown. To evaluate the effect of treatment with a combination of melphalan, prednisone, and thalidomide (MPT), researchers in Italy describe treatment outcomes for 49 newly diagnosed multiple myeloma patients who were treated with MPT:
- 24% of patients achieved a complete or near-complete disappearance of myeloma.
- 49% of patients achieved a partial disappearance of myeloma.
- 6% of patients did not respond to treatment, and myeloma worsened in 10% of patients.
- The median time to maximum treatment response was four months.
- Ninety-one percent of patients survived for at least two years.
- Common adverse effects of treatment with MPT included abnormal blood cell counts (22% of patients), blood clots (20% of patients), and infections (12% of patients).
- One patient died of a pulmonary thromboembolism (a blood clot in the lungs).
The researchers conclude that treatment of multiple myeloma with MPT merits further investigation in randomized clinical trials. Response to this combination of drugs appears to be good, though treatment with an anticoagulant may be necessary to prevent blood clots.
Patients with multiple myeloma may wish to talk with their doctor about the risks and benefits of participating in a clinical trial further evaluating therapeutic options.
Reference: Palumbo A, Bertola A, Musto P et al. Oral Melphalan, Prednisone, and Thalidomide for Newly Diagnosed Patients with Myeloma. Cancer. 2005;104:1428-33.