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October 4, 2007 NEW YORK (Reuters Health) - In elderly patients with multiple myeloma, adding thalidomide to melphalan plus prednisone (MP), the standard therapy for the disease, can significantly improve overall survival, according to a report in the October 6th issue of The Lancet. Dr. Thierry Facon, from Hopital Claude Huriez in Lille, France, and colleagues assessed survival in 447 previously untreated patients, between 65 and 75 years of age, who were randomized to receive MP alone, MP plus thalidomide (MPT), or reduced-intensity stem cell transplantation using melphalan. The median follow-up period was 51.5 months. The median survival period in the MPT group was 51.6 months compared with periods of just 33.2 and 38.3 months in the MP and stem cell groups, respectively. In terms of overall survival, MPT reduced the risk of death by 41% and 31% relative to MP (p = 0.0006) and stem cell transplantation (p = 0.027), respectively. No significant difference in survival was seen between the MP and stem cell groups. "The results of our trial provide strong evidence to suggest that the MPT combination should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma," the researchers state. The authors of a related editorial agree with this conclusion. "After 50 years of unsuccessful attempts to find new and more effective treatment approaches suitable for most patients, we now have extensive evidence to support the introduction of MPT as the standard of care for elderly patients. Copyright 2008 Reuters. Click for Restrictions.
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