Thalidomide Treatment for Immunoglobulin D Multiple Myeloma in a Patient on Chronic Hemodialysis

A 64-year-old Japanese man suffering from IgD λ myeloma and renal failure requiring chronic hemodialysis was treated with thalidomide. Serum IgD concentration was 4, 050 mg/dl and myeloma cells constituted 95.6% of nucleated cells in bone marrow at the start of treatment. These parameters improved markedly to 1, 590 mg/dl and 22.0%, respectively, in the 4 months immediately prior to his death due to pneumonia. Thalidomide caused peripheral neuropathy and constipation at a dose of 100 mg daily in the first week of treatment, but adverse effects resolved upon dose reduction. Thalidomide represents a valid therapeutic option for some myeloma patients receiving hemodialysis.(Internal Medicine 42: 605-608, 2003)