Survival advantage of adding thalidomide as compared with chemotherapy only in the treatment of symptomatic myeloma in Kurdistan/Iraq
Ahmed K Yassin
Consultant internist & clinical hematologist and Lecturer Nanakaly hospital for blood diseases, Hawler medical university/ Erbil/Iraq
Source of Support: None, Conflict of Interest: None
Background: Multiple myeloma is an incurable plasma cells neoplasm. Chemotherapy by the alkylating agent Melphalan was introduced in 1958 and with the addition of prednisolone in 1964 the combination (MP) improved the survival of these patients and remained the standard treatment for over twenty years. In 1998 the antiangiogenic reagent thalidomide was tried and claimed to further improve survival of these patients including those with advanced disease. Objectives: This study was conducted to determine the difference in survival of multiple myeloma patients in Nanakaly Hospital in Erbil city before and after the use of thalidomide. Patients and Methods: This retrospective study was carried out at Nanakaly Hospital over a period of six years from January 2007 to March 2013. The records 123 patients with symptomatic multiple myeloma who were treated in this period were reviewed, including their clinical and laboratory profiles, as well as the survival of each group. All patients were selected according to the WHO diagnostic criteria.
Results: The patients had a median age of 59 years and the male: female ratio of 1.2:1, Chemotherapy based treatment was used in 38 patients as compared with 85 patients who used thalidomide based therapy.
Median survival was 34 months for thalidomide compared to 19 months for chemotherapy-only treated group (P= 0.001)
Conclusions: The introduction of Thalidomide as a therapeutic option in Iraqi patients improved survival of symptomatic myeloma significantly compared to chemotherapy alone.