{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:47:41Z","timestamp":1778629661544,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,10,9]],"date-time":"2008-10-09T00:00:00Z","timestamp":1223510400000},"content-version":"vor","delay-in-days":3113,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2000,4]]},"abstract":"<jats:p>Twenty\u2010three patients with advanced and heavily pretreated myeloma were treated with thalidomide. Starting dose was 200\u2003mg\/d, and 20 patients had dose escalations up to 400 (<jats:italic>n<\/jats:italic>\u2003=\u20035), 600 (<jats:italic>n<\/jats:italic>\u2003=\u200312) or 800\u2003mg\/d (<jats:italic>n<\/jats:italic>\u2003=\u20033), usually in divided doses. Nineteen patients were refractory to recent chemotherapy, and four had untreated relapse after prior intensive therapy. Ten out of 23 patients (43%) achieved partial response (PR; nine with refractory and one with relapsed disease), six patients had minor response or stabilization of the disease and four had disease progression. Another three patients died early from advanced myeloma at less than 3\u2003weeks of thalidomide therapy. Of the 10 patients with PR, seven had a better response than after any prior therapy, despite vincristine\u2013doxorubicin\u2013dexamethasone (VAD)\u2010based treatment in all but one and high\u2010dose melphalan with autologous stem cell support in four. Time to achieve PR was rapid in patients receiving thalidomide in divided doses (median 31\u2003d). Responses also included reduced bone marrow plasma cell infiltration and improved general status. Normalized polyclonal gammaglobulin levels were seen in four cases. Six out of 10 patients with PR remained in remission with a median time on treatment of 23\u2003weeks (range 15\u201350\u2003weeks). Sedation was common but usually tolerable, and some patients continued full\u2010 or part\u2010time work. Four patients had skin problems, three patients had pneumonia, one hypothyrosis, one sinus bradycardia and one minor sensory neuropathy. Thalidomide may induce good partial remissions in advanced refractory myeloma with tolerable toxicity, and should be evaluated in other settings for myeloma patients. Divided thalidomide doses seem to reduce time to achieve remission and may improve response rate.<\/jats:p>","DOI":"10.1046\/j.1365-2141.2000.01983.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T06:23:09Z","timestamp":1047363789000},"page":"89-96","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":177,"title":["Frequent good partial remissions from thalidomide including best response ever in patients with advanced refractory and relapsed 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