Melphalan, Prednisone & Thalidomide in newly diagnosed MM patients

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 .

Melphalan, prednisone and thalidomide are established treatment options for multiple myeloma. The effect, however, of combining these three drugs is unknown. Researchers in Italy describe treatment outcomes for 49 newly diagnosed multiple myeloma patients who were treated with a combination of 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.
• 91% 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.