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Thalidomide as a targeted therapy for multiple myeloma.

Multiple myelomais a highly malignant hematological disease and is hardly cured with conventional chemotherapy. Although high-dose chemotherapy with autologous stem cell transplantation increases the complete remission rate and improves event free survival and over all survival (1, 2), there is no plateau of the survival curves and many patients still relapse (3, 4). Therefore several strategies concerning the methods of transplantation, such as the conditioning regimen, number of transplantations, source of stem cells and allogeneic transplantation, are under investigation to improve the treatment results. Manymalignant neoplasms such as breast, prostate and non small cell lung cancers are dependent on neovascularization to sustain growth. Recently increased blood vessel formation (angiogenesis) in the bone marrow of the patients with multiple myelomawas reported (5) and elevated levels of several angiogenic cytokines in patients with myeloma was also reported (6). In 1994, D'Amato et al (7) reported that orally administered thalidomide was an inhibitor of