Abstract
The management of acute myeloid leukemia (AML), high-risk myelodysplastic syndromes (MDS), and myeloproliferative disorders remains challenging because of the inability of even the most effective treatment strategies to produce durable complete remissions. Bone marrow transplant (BMT) is one such modality with potentially curative benefit; however, its applicability generally is limited to patients of younger age with suitable donors. Therefore, novel agents and alternative therapeutic strategies need to be studied. The role of angiogenesis in hematologic malignancies has been elucidated by several investigators; hence, inhibitors of angiogenesis are being studied in these disorders. Thalidomide appears to have both antiangiogenic and immunosuppressive properties and has shown promising results in the treatment of refractory or relapsed multiple myeloma and plasma cell leukemia. Consequently, pilot studies of thalidomide for the treatment of other hematologic disorders, including refractory/relapsed AML, high-risk MDS, myeloproliferative disorders, and myelofibrosis are underway at M.D. Anderson Cancer Center. Preliminary results indicate that thalidomide has activity and is well tolerated in the treatment of these hematologic disorders, and thus warrants further evaluation.
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