Abstract
Elevated levels of TNF-alpha have been associated with progressive disease in patients with chronic lymphocytic leukemia (CLL). Thalidomide has been shown to inhibit production of TNF-alpha. We investigated the effects of thalidomide on clinical outcome and TNF-alpha 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-alpha levels did not show any decrease during treatment. Low-dose thalidomide is not effective in CLL patients with refractory disease.
MeSH terms
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Administration, Oral
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Aged
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Cyclophosphamide / administration & dosage*
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Cyclophosphamide / adverse effects
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Disease Progression
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Dose-Response Relationship, Drug
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Drug Administration Schedule
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Female
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Follow-Up Studies
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Humans
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Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
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Male
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Middle Aged
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Prospective Studies
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Thalidomide / administration & dosage*
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Thalidomide / adverse effects
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Treatment Failure
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Tumor Necrosis Factor-alpha / blood
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Vidarabine / administration & dosage
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Vidarabine / adverse effects
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Vidarabine / analogs & derivatives*
Substances
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Tumor Necrosis Factor-alpha
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Thalidomide
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Cyclophosphamide
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Vidarabine
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fludarabine