A recent study has shown that thalidomide (Thalomid) given with prednisone can improve survival in multiple myeloma patients who have undergone autologous stem cell transplantation (ASCT). Thalidomide has been known to be effective in patients with newly diagnosed and relapsed/refractory myeloma, but its effect after ASCT has not been known.

In this study, 269 patients with newly diagnosed but stable myeloma underwent ASCT that had been conditioned with single high-dose melphalan (Alkeran). After the ASCT, 129 of the patients were given prednisone-only therapy, while 114 received a prednisone-thalidomide combination. The therapy lasted for 12 months.

After three years, progression-free survival in the prednisone-thalidomide group was 42 percent compared to the prednisone-only group’s 23 percent. Similarly, overall survival in the prednisone-thalidomide group was 86 percent compared to the prednisone-only group’s 75 percent.

While the occurrence of neurological side effects was slightly elevated in the prednisone-thalidomide group, no difference in the occurrence of thromboembolic events was evident between the two groups.

The researchers conclude that overall survival increases in patients who are given 12 months of thalidomide with prednisone after ASCT that has been conditioned with single high-dose melphalan.

See the article in the Journal of Clinical Oncology (abstract) for further details.