Thalidomide Doxorubicin

DOXORUBICIN THALIDOMIDE t risk (up to sixfold) of deep venous thrombosis in patients with multiple myeloma compared with those treated without doxorubicin Uncertain. Attributed to doxorubicin contributing to the thrombogenic activity Avoid co-administration - except in clinical trials... 

Hydrogen sulfide Polychlorinated biphenyls Tri-o-tolyl phosphate Cisplatin Chlorpromazine Doxorubicin Thalidomide Valproic acid Botulinum toxin... 

The incidence of deep venous thrombosis is increased by the co-administration of doxorubicin, as suggested by a study in 232 patients with multiple myeloma who received a combination of thahdomide and chemotherapy in two protocols that differed only by the inclusion of doxorubicin in one DT-PACE (dexamethasone -I- thahdomide -I-cisplatin -I- doxorubicin + cyclophosphamide -I- etoposide) and DCEP-T (dexamethasone + cyclophosphamide -I-etoposide -I- cisplatin + thalidomide) (25). There was an increased risk of deep venous thrombosis in those who received DT-PACE but not in those who received DCEP-T. Multivariate analysis confirmed that those who received thahdomide + doxorubicin had an increased risk of deep venous thrombosis. In two separate trials in patients taking thahdomide for multiple myeloma, deep venous thrombosis occurred in four of 15 patients who received concomitant treatment with doxorubicin -I- dexamethasone compared with three of 45 who received dexamethasone only (26). 

Fassas A, Morris C, Fink L, Tricot G. Thrombogenic activity of doxorubicin in myeloma patients receiving thalidomide implications for therapy. Blood... 

The concurrent use of thalidomide and doxorubicin is associated with an increased risk of deep-vein thrombosis in patients with multiple myeloma. 

In a study in 100 patients with newly diagnosed multiple myeloma given induction chemotherapy (dexamethasone, vincristine, doxorubicin, cyclophosphamide, etoposide and cisplatin) with or without thalidomide, deep vein thrombosis developed in 14 of the 50 patients (28%) given thalidomide compared with 2 of 50 patients (4%) not given thalidomide. Deep vein thrombosis has been reported to occur in 10% of patients treated for multiple myeloma but is reported to occur in about 2% in patients with multiple myeloma treated with thalidomide alone. ... 

In contrast to the variably invasive loco-regional ablative therapies, there are no valid data on systemic hormonal, chemotherapeutic, antiangiogenic, or receptor-directed therapies with 5 -fluorouracil, doxorubicin, epirubicin, etoposide, cisplatin, and mito-xantrone, or with interferon, tamoxifen, capecitabine, thalidomide, and octreotide, in terms of their ability to improve patient survival or life quality in early or advanced HCC (Aguayo and Patt 2001). 

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