摘要 : We read with interest the data from Grey-Davies et al, which demonstrates the activity of the combination of bendamustine, thalidomide and dexamethasone in a proportion of multiply relapsed cohort of myeloma patients. We have prev... 展开 We read with interest the data from Grey-Davies et al, which demonstrates the activity of the combination of bendamustine, thalidomide and dexamethasone in a proportion of multiply relapsed cohort of myeloma patients. We have previously published the safety and activity of this combination in myeloma patients with renal impairment (Ramasamy et al, 2011). However, the optimal dose of bendamustine in combination with thalidomide and dexamethasone is yet to be denned. We used a fixed dose of 120 mg of bendamustine per cycle, which was tolerated well, with Grade 3/4 haemato-logical toxicity in two out of nine patients. In this heavily pre-treated cohort with pre-existing cytopenias, 39% emergent Grade 3/4 haematological toxicity was observed at a cumulative median bendamustine dose of 390 mg/m2. We hope the current Myeloma UK (MUK one) trial, a Phase II randomized bendamustine dose-finding study in combination with thalidomide and dexamethasone, will shed light on a dosing strategy. 收起