{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:41:41Z","timestamp":1774438901372,"version":"3.50.1"},"reference-count":32,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Major progress has occurred in multiple myeloma (MM) treatment in recent years, but this is not seen in low- and middle-income countries. <\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS<\/jats:title><jats:p> We retrospectively assessed the efficacy and safety of cyclophosphamide, thalidomide, and dexamethasone (cyclophosphamide 400 mg\/m<jats:sup>2<\/jats:sup> for 5 days, thalidomide 100 mg once daily, if tolerated, and dexamethasone 40 mg once weekly; in 28-day cycles) in patients with newly diagnosed MM treated at our institution between April 2008 and December 2012. Survival outcomes were estimated by the Kaplan-Meier method. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Fifty-nine patients were found to meet the selection criteria. Median age was 56 years (27-78). Fifty-nine percent (n = 35) were male. International Staging System three was found in 24%. The median number of treatment cycles was 11 (range 4-12). After a median of 81-month follow-up (range 5-138 months), the overall response rate was 69.5%. The complete response and very good partial response were 5% and 32%, respectively. Median progression-free survival (PFS) was 35 months (95% CI, 18 to 41). The 3-year PFS was 47.4% (95% CI, 34.5 to 59.6) and 5-year PFS was 24.9% (95% CI, 14.4 to 36.9). The median of overall survival (OS) was 81 months (95% CI, 33 to not reached). The 3-year OS was 63.4% (95% CI, 49.2 to 74.6), and 5-year OS was 57.5% (95% CI, 43.2 to 69.4). The most common adverse event was neutropenia (grade 3 and 4, 30.5%). Out of 23 patients eligible for stem-cell transplantation, 10 (43.5%) proceeded with autologous transplantation. Treatment-related deaths occurred in four patients (6.7%). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Cyclophosphamide, thalidomide, and dexamethasone achieves good response rates with tolerable toxicity, especially in patients age 65 years or younger representing a feasible approach for patients with MM in low-income health care settings. <\/jats:p><\/jats:sec>","DOI":"10.1200\/go.20.00665","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T19:59:33Z","timestamp":1627070373000},"page":"1199-1205","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":6,"title":["Cyclophosphamide, Thalidomide, and Dexamethasone as Initial Therapy for Patients With Newly Diagnosed Multiple Myeloma in a Middle-Income Country: 7-Year Follow-Up"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6477-4660","authenticated-orcid":false,"given":"Jule","family":"Vasquez","sequence":"first","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5199-6686","authenticated-orcid":false,"given":"Rossana","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1495-4396","authenticated-orcid":false,"given":"Karina","family":"Aliaga","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-0570","authenticated-orcid":false,"given":"Fernando","family":"Valencia","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Villena","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1879-2486","authenticated-orcid":false,"given":"Shirley","family":"Quintana","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-4560","authenticated-orcid":false,"given":"Tatiana","family":"Vidaurre","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Enfermedades Neopl\u00e1sicas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Casanova","sequence":"additional","affiliation":[{"name":"Instituto Oncol\u00f3gico Miraflores, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041875"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21332"},{"key":"b3","volume-title":"Registro de C\u00e1ncer de Lima Metropolitana 2004-2005. 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