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Terpos, E. et al.

Terpos, Mihou, Szydlo, Tsimirika, Karkantaris, Politou, Voskaridou, Rahemtulla, Dimopoulos, Zervas,

The combination of intermediate doses of thalidomide with dexamethasone is an effective treatment for patients with refractory/relapsed multiple myeloma and normalizes abnormal bone remodeling, through the reduction of sRANKL/osteoprotegerin ratio.

The aim of this study was the evaluation of the effect of intermediate doses of thalidomide with dexamethasone (Thal/Dex) on disease course and bone disease in patients with refractory/relapsed myeloma who were under zoledronic acid therapy. We studied 35 patients, who received thalidomide at a dose of 200 mg/daily. We measured, pre-, 3 and 6 months post-treatment soluble receptor activator of nuclear factor-kappaB ligand (sRANKL), osteoprotegerin ( OPG), osteopontin ( OPN), markers of bone resorption and formation. Before treatment, patients had increased levels of sRANKL/ OPG ratio, bone resorption markers and OPN, while they had suppressed bone formation. The pretreatment sRANKL/ OPG ratio correlated with the extent of bone disease. Thal/Dex administration resulted in a significant reduction of sRANKL/ OPG ratio, and bone resorption. Bone formation, OPG and OPN did not show any alteration. Changes of sRANKL/ OPG ratio correlated with changes of bone resorption markers. Thal/Dex was given for a median time of 10 months and the median follow-up period was 22 months. The response rate was 65.7%. The median survival was 19.5 months. beta2-microglobulin, type of response and International Staging System predicted for survival. These results suggest that the combination of intermediate dose of Thal/Dex is effective in patients with refractory/relapsed myeloma and improves abnormal bone remodeling through the reduction of sRANKL/ OPG ratio.[1]

References

The combination of intermediate doses of thalidomide with dexamethasone is an effective treatment for patients with refractory/relapsed multiple myeloma and normalizes abnormal bone remodeling, through the reduction of sRANKL/osteoprotegerin ratio. Terpos, E., Mihou, D., Szydlo, R., Tsimirika, K., Karkantaris, C., Politou, M., Voskaridou, E., Rahemtulla, A., Dimopoulos, M.A., Zervas, K. Leukemia (2005) [Pubmed]

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