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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    2013, Vol. 7 Issue (3) : 290-300     DOI: 10.1007/s11684-013-0277-z
REVIEW |
Therapeutic effects of thalidomide in hematologic disorders: a review
Miao Xu1, Yu Hou2, Lei Sheng3, Jun Peng1()
1. Department of Hematology, Qilu Hospital, Shandong University, Jinan 250012, China; 2. Shandong University School of Medicine, Jinan, Shandong, 250012, China; 3. Department of General Surgery, Qilu Hospital, Shandong University, Jinan 250012, China
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Abstract  

The extensive autoimmune, anti-inflammatory, and anticancer applications of thalidomide have inspired a growing number of studies and clinical trials. As an inexpensive agent with relatively low toxicity, thalidomide is regarded as a promising therapeutic candidate, especially for malignant diseases. We review its therapeutic effects in hematology, including those on multiple myeloma, Waldenstroem macroglobulinemia, lymphoma, mantle-cell lymphoma, myelodysplastic syndrome, hereditary hemorrhagic telangiectasia, and graft-versus-host disease. Most studies have shown satisfactory results, although several have reported the opposite. Aside from optimal outcomes, the toxicities and adverse effects of thalidomide should also be examined. The current work includes a discussion of the mechanisms through which the novel biological effects of thalidomide occur, although more studies should be devoted to this aspect. With appropriate safeguards, thalidomide may benefit patients suffering from a broad variety of disorders, particularly refractory and resistant diseases.

Keywords thalidomide      multiple myeloma      lymphoma     
Corresponding Authors: Peng Jun,Email:junpeng88@sina.com.cn   
Issue Date: 05 September 2013
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-013-0277-z     OR     http://academic.hep.com.cn/fmd/EN/Y2013/V7/I3/290
Fig.1  Mechanism of thalidomide on MM cells. Thalidomide arrests MM cells in the G phase by inhibiting the bond between stromal and MM cells. According to studies, metastasis is correlated with vascular proliferation. Thalidomide can decrease cytokine production by stromal cells, such as VEGF, thereby preventing angiogenesis. Thalidomide inhibits the production of IL-6 and TNF-β, which assists the growth of MM cells and promotes IFN-γ secretion, which leads to the apoptosis of MM cells. It also stimulates T cells and NKT cells by increasing the IL-2 level. Both T and NKT cells have cytotoxic effects on MM cells.
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