Combination of thalidomide,calcitriol and andarsenic trioxide in the treatment of myelodysplastic syndrome

Objective To study the efficacy and tolerance of the combination of thalidomide,calcitriol and andarsenic trioxide in the treatment of myelodysplastic syndrome. Methods all patiens were randomly divided into two groups:treatment group and control group. 22 cases in treatment group:thalidomide orally every night before going to bed,the initial,The initial dose of thalidomide was 50 mg/d,then increased 50 mg/ d every week until the patients reached maximal tolerance 300mg/d ,the maintain dose was 100-200 mg/d. Calcitriol was administered 2μg/d for 3 months. Arsenic trioxide was administered 10 mg/d,intravenous infusion,20 times per month,3 weeks interval for a course of treatment. 22 cases in control group were administered male hormone,interferon,all-trans retinoic acid or low-dose chemotherapy. Results In the treatment group,19 (5 CR ,6 PR ,8 HI) of 22 patients had an objective response (86.36 %). The side-effect was gentle inclucling fatigue,constipation,edema,tetter and abnormality of liver function and kidney function. In the control group,9 (2 PR,7 HI) of 22 patients had an objective response (40.90%). The response rate between two groups were significant different (P0.05). Conclusion The combination of thalidomide,calcitriol and andarsenic trioxide thalidomide was efficient and well tolerated in the treatment of patients with myelodysplastic syndrome.