Low-Dose Thalidomide Unhelpful in Refractory CLL

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Leukemia Research

Volume 31, Issue 2 , February 2007, Pages 253-256

Copyright © 2006 Elsevier Ltd All rights reserved.

Brief communication

Low-dose thalidomide in combination with oral fludarabine and

cyclophosphamide is ineffective in heavily pre-treated patients with

chronic lymphocytic leukemia

Luca tia, , Paola Piccionia, Michela Tarnania, De

Paduaa, grazia Garziaa, Dimiter G. Efremovb, , Nicola

Piccirilloa, Patrizia Chiusoloa, Simona Sicaa and Giuseppe Leonea

aDepartment of Haematology, Catholic University of Sacred Heart of

Rome, Italy

bICGEB Monterotondo Outstation, CNR Campus A. Buzati-Traverso, Roma,

Italy

Received 16 May 2006; revised 16 May 2006; accepted 19 May 2006.

Available online 3 July 2006.

Abstract

Elevated levels of TNF-á have been associated with progressive

disease in patients with chronic lymphocytic leukemia (CLL).

Thalidomide has been shown to inhibit production of TNF-á.

We investigated the effects of thalidomide on clinical outcome and

TNF-á serum levels in five pre-treated CLL patients. The schedule

consisted on daily thalidomide (Thal), oral fludarabine (Flu) and

oral cyclophosphamide (CTX). Median duration of treatment was 60

days; four patients stopped treatment for disease progression and

one patient for neurological toxicity. Serum TNF-á levels did not

show any decrease during treatment.

Low-dose thalidomide is not effective in CLL patients with

refractory disease.