Clinical analysis of thalidomide combined with cyclosporin A and arsenic trioxide in the treatment of myelodysplastic syndrome

Objective:To evaluate the efficacy and safety of thalidomide combined with cyclosporin A and arsenic trioxide in the treatment of myelodysplastic syndrome. Method:37 patiens were divided into 2 groups: therapy group and control group, 21 patiens were enrolled in therapy group, The initial dose of Thalidomide was 100 mg/d, then increased 50 mg/d every week until the patients reached maximal tolerance,the maintain dose was 100~200 mg/d. Cyclosporin A was taken 5.0 mg/(kg·d) orally in the first 3 months, then was corrected to 2.5~5.0 mg/(kg·d). During 4 weeks of each 6-week cycle,Arsenic trioxide was administered 10 mg/d, followed by ascorbic acid 3 g/d, ivgtt, for days 1~5/w. All patients maintain treatment 3~6 cycles. In the control group, 16 patients were administered male hormone, interferon, all-trans-retinoic acid (ATRA) or low dosage chymic therapy.Result:In the therapy group,19 (2 CR, 5 PR, 9 HI) of 21 patients had an objective response (76.19%). The side effect was gentle inclucling fatigue, constipation, edema, tetter and abnormality of liver function and kidney function. In the control group, 7(2 PR, 5 HI) of 16 patients had an objective response (43.75%). The response rate between two groups were significant different (P0.05). Conclusion:Thalidomide combined with cyclosporin A and arsenic trioxide in the treatment of patients with myelodysplastic syndrome was efficient and side effect was tolerable.