scholarly journals Bronchoscopic Local Nd:YAG Laser Hyperthermia in the Treatment of Lung Cancer

1995 ◽  
Vol 1 (3) ◽  
pp. 159-164
Author(s):  
Ryosuke Ono
Keyword(s):  
Lung Cancer ◽  
Local Recurrence ◽  
Partial Response ◽  
Nd:Yag Laser ◽  
Alternative Therapy ◽  
Complete Response ◽  
Cancer Center ◽  
Laser Hyperthermia ◽  
Center Hospital

Between March 1989 and July 1990, 13 patients with tracheobronchial cancer were treated by laser hyperthermia at the National Cancer Center Hospital. A complete response was achieved in 9 patients (with 9 carcinoma lesions), with no evidence of local recurrence on follow-up ranging from 4 to 29 months. Four patients had a partial response, requiring alternative therapy.The surface area of the lesions showing complete response was less than 3 cm2. These lesions had a superficial appearance by bronchoscopic observation. Our experience suggests that laser hyperthermia may be a useful alternative to surgical resection in patients with small localized tumors confined within the tracheobronchial wall.

scholarly journals Post-mastectomy radiation therapy without usage of a bolus may be a reasonable option

2017 ◽  
Vol 58 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Naoki Nakamura ◽  
Satoko Arahira ◽  
Sadamoto Zenda ◽  
Kimiyasu Yoneyama ◽  
Hirofumi Mukai ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Recurrence ◽  
Locoregional Recurrence ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Cancer Center ◽  
Luminal Subtype ◽  
Center Hospital ◽  
Grade 3

Abstract To clarify the efficacy and toxicity of post-mastectomy radiation therapy (PMRT) without usage of a bolus, we identified 129 consecutive patients who received PMRT at the National Cancer Center Hospital East between 2003 and 2012. Seven of the 129 patients who received breast reconstruction before PMRT were excluded. All patients received PMRT of 6 MV photons, without usage of a bolus. The median follow-up duration for all eligible patients was 47.7 months (range: 4.0–123.2). Local, locoregional and isolated locoregional recurrence was found in 12 (9.8%), 14 (11%) and 5 patients (4.1%), respectively. The 3- and 5-year cumulative incidence of local recurrence, locoregional recurrence and isolated locoregional recurrence was 9.2 and 10.7%, 10.8 and 12.4%, and 4.3 and 4.3%, respectively. Although Grade 2 dermatitis was found in 11 patients (9.0%), no Grade 3–4 dermatitis was found. On univariate analysis, only a non-luminal subtype was a significant predictor for local recurrence (P < 0.001). On multivariate analysis, a non-luminal subtype remained as an independent predictor for local recurrence (P = 0.003, odds ratio: 10.9, 95% confidence interval: 2.23–53.1). In conclusion, PMRT without usage of a bolus resulted in a low rate of severe acute dermatitis without an apparent increase in local recurrence. PMRT without usage of a bolus may be reasonable, especially for patients with a luminal subtype.

scholarly journals Sequential Versus Concurrent Thoracic Radiotherapy in Combination With Cisplatin and Etoposide for N3 Limited-Stage Small-Cell Lung Cancer

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482095661
Author(s):  
Zhenbo Wang ◽  
Jinliang Wan ◽  
Changmin Liu ◽  
Lei Li ◽  
Xinjun Dong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Partial Response ◽  
Small Cell Lung Cancer ◽  
Response Rate ◽  
Complete Response Rate ◽  
Complete Response ◽  
Small Cell ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung

At present, concurrent chemoradiotherapy (CRT) is considered the standard treatment of limited-stage small cell lung cancer (LS-SCLC). However, LS-SCLC is highly heterogeneous in the T stage, N stage, and prognosis. Increasing evidence has shown that individual treatment should be considered when treating LS-SCLC patients. The aim of the present study was to explore the optimal combination model of thoracic radiotherapy (TRT) and chemotherapy in N3 LS-SCLC. We retrospectively analyzed 93 N3 LS-SCLC patients treated in the Department of Oncology of Binzhou Medical University Hospital (Shandong, China) between March 2010 and October 2015. A total of 52 (52/93; 55.9%) patients received sequential CRT, and 41 (41/93; 44.1%) patients received concurrent CRT. All patients received 4-6 cycles of chemotherapy and TRT (50-60 Gy). The median follow-up time was 25.4 months (range was 6-65 months).The overall response rate was 88.5% in the sequential CRT group (9.6% complete response rate and 78.8% partial response rate) and 90.2% in the concurrent CRT group (14.6% complete response rate and 75.6% partial response rate). The PFS and OS were 15.4 months and 19.1 months in sequential CRT group, and 16.9 months and 20.5 months in concurrent CRT group. There was no significant difference in treatment response rate, PFS, and OS between sequential and concurrent CRT patients. The most common treatment-related toxicities were nausea/vomiting, neutropenia, and esophagitis. In conclusion, when concurrent CRT is performed in N3 LS-SCLC patients, tolerance to treatment should be fully considered. In our study, sequential CRT and concurrent CRT showed the same efficacy, and sequential CRT demonstrated better tolerance. However, these results require confirmation in future follow-up studies.

scholarly journals Post-Neoadjuvant Surveillance and Surgery as Needed Compared with Post-Neoadjuvant Surgery on Principle in Multimodal Treatment for Esophageal Cancer: A Scoping Review

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 429
Author(s):  
Julian Hipp ◽  
Blin Nagavci ◽  
Claudia Schmoor ◽  
Joerg Meerpohl ◽  
Jens Hoeppner ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Local Recurrence ◽  
Scoping Review ◽  
Multimodal Treatment ◽  
Neoadjuvant Treatment ◽  
Complete Response ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
Randomized Controlled

Background: A substantial fraction of patients with esophageal cancer show post-neoadjuvant pathological complete response (pCR). Principal esophagectomy after neoadjuvant treatment is the standard of care for all patients, although surveillance and surgery as needed in case of local recurrence may be a treatment alternative for patients with complete response (CR). Methods: We performed a scoping review to describe key characteristics of relevant clinical studies including adults with non-metastatic esophageal cancer receiving multimodal treatment. Until September 2020, relevant studies were identified through systematic searches in the bibliographic databases Medline, Web of Science, Cochrane Library, Science Direct, ClinicalTrials, the German study register, and the WHO registry platform. Results: In total, three completed randomized controlled trials (RCTs, with 468 participants), three planned/ongoing RCTs (with a planned sample size of 752 participants), one non-randomized controlled study (NRS, with 53 participants), ten retrospective cohort studies (with 2228 participants), and one survey on patients’ preferences (with 100 participants) were identified. All studies applied neoadjuvant chemoradiation protocols. None of the studies examined neoadjuvant chemotherapeutic protocols. Studies investigated patient populations with esophageal squamous cell carcinoma, adenocarcinoma, and mixed cohorts. Important outcomes reported were overall, disease-free and local recurrence-free survival. Limitations of the currently available study pool include heterogeneous chemoradiation protocols, a lack of modern neoadjuvant treatment protocols in RCTs, short follow-up times, the use of heterogeneous diagnostic methods, and different definitions of clinical CR. Conclusion: Although post-neoadjuvant surveillance and surgery as needed compared with post-neoadjuvant surgery on principle has been investigated within different study designs, the currently available results are based on a wide variation of diagnostic tools to identify patients with pCR, short follow-up times, small sample sizes, and variations in therapeutic procedures. A thoroughly planned RCT considering the limitations in the currently available literature will be of great importance to provide patients with CR with the best and less harmful treatment.

scholarly journals ACUTE LYMPHOBLASTIC LEUKEMIA EXPERIENCE: EPIDEMIOLOGY AND OUTCOME OF TWO DIFFERENT REGIMENS

2013 ◽  
Vol 5 (1) ◽  
pp. e2013024 ◽  
Author(s):  
Salah Abbasi ◽  
Faten Maleha ◽  
Muhannad Shobaki
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Medical Records ◽  
Residual Disease ◽  
Lymphoblastic Leukemia ◽  
Complete Response ◽  
Cancer Center ◽  
Poor Prognostic Factor ◽  
Minimal Residual Disease Monitoring ◽  
Adult Acute Lymphoblastic Leukemia

Objectives. Accurate data about adult acute lymphoblastic leukemia (ALL) are lacking. We aim to assess demographics, prognostic factors, and outcome of ALL therapy at King Hussein Cancer Center (KHCC) in Jordan, and to compare the efficacy of two protocols.Methods. We reviewed medical records of adults diagnosed and treated for ALL at KHCC from January, 2006 to December, 2010.Results. Over a 5-year period, 108 patients with ALL were treated (66 with the Hyper-CVAD regimen, and 42 with the CALGB 8811 regimen). Median age at diagnosis was 33 years, with 63% males. The most common immunophenotype was CD10-positive common ALL, and 16% have BCR-ABL translocation. Complete response (CR) rate was 88%. After a median follow-up of 32 months (range, 10-72 months), the median survival (MS) was 30 months, and CR duration (CRD) was 28 months. In the multivariate analysis, the presence of BCR-ABL translocation was the only poor prognostic factor with lower MS of 23 months (p<0.01). There was no difference in MS or CRD between the two used regimens.Conclusion. International protocols for adult ALL were successfully applied to our patients. There is no difference in efficacy between Hyper-CVAD and CALGB 8811 regimens. Future protocols for adult ALL should incorporate new targeted agents and minimal residual disease monitoring to improve outcome.

Lessons from pathological analysis of recurrent early esophageal squamous cell neoplasia after complete endoscopic radiofrequency ablation

Endoscopy ◽  
2018 ◽  
Vol 50 (08) ◽  
pp. 743-750 ◽  
Author(s):  
Wen-Lun Wang ◽  
I-Wei Chang ◽  
Chien-Chuan Chen ◽  
Chi-Yang Chang ◽  
Cheng-Hao Tseng ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Complete Response ◽  
Primary Treatment ◽  
Long Term Follow Up ◽  
Endoscopic Radiofrequency Ablation ◽  
Lost To Follow Up

Abstract Background Endoscopic radiofrequency ablation (RFA) is a treatment option for early esophageal squamous cell neoplasia (ESCN); however, long-term follow-up studies are lacking. The risks of local recurrence and “buried cancer” are also uncertain. Methods Patients with flat-type ESCN who were treated with balloon-type ± focal-type RFA were consecutively enrolled. Follow-up endoscopy was performed at 1, 3, and 6 months, and then every 6 months thereafter. Endoscopic resection was performed for persistent and recurrent ESCN, and the histopathology of resected specimens was assessed. Results A total of 35 patients were treated with RFA, of whom 30 (86 %) achieved a complete response, three were lost to follow-up, and five (14 %) developed post-RFA stenosis. Two patients had persistent ESCN and received further endoscopic resection, in which the resected specimens all revealed superficial submucosal invasive cancer. Six of the 30 patients with successful RFA (20 %) developed a total of seven episodes of local recurrence (mean size 1.4 cm) during the follow-up period (mean 40.1 months), all of which were successfully resected endoscopically without adverse events. Histological analysis of the resected specimens revealed that six (86 %) had esophageal glandular ductal involvement, all of which extended deeper than the muscularis mucosae layer. Immunohistochemistry staining for P53 and Ki67 suggested a clonal relationship between the ductal involvement and epithelial cells. None of the tumors extended out of the ductal structure; no cases of cancer buried beneath the normal neosquamous epithelium were found. Conclusions Because ductal involvement is not uncommon and may be related to recurrence, the use of RFA should be conservative and may not be the preferred primary treatment for early ESCN.

Possible immunologic predictors of the PD-1/PD-L1 checkpoint inhibitors' efficiency in lung cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21035-e21035
Author(s):  
Elena Yu. Zlatnik ◽  
Oleg I. Kit ◽  
Elena S. Bondarenko ◽  
Aleksandr B. Sagakyants ◽  
Maria A. Teplyakova ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Partial Response ◽  
Checkpoint Inhibitors ◽  
Complete Response ◽  
Response To Treatment ◽  
Cell Mediated Immunity ◽  
Initial Amount ◽  
Lung Cancer Patients ◽  
Effect Of Therapy ◽  
Check Point Inhibitors

e21035 Background: Immunotherapy with PD-1/PD-L1 check-point inhibitors (CPI) is a new trend in oncology. Their effect significantly depends on the patients` immune status. The aim of the study was to search the immunologic parameters of lung cancer (LC) patients receiving immunotherapy as factors that could predict their effect. Methods: 20 patients (12 male and 8 female) with LC had adenocarcinoma – 15 (75%), squamous cell carcinoma – 5 (25%). PD-1/PD-L1 CPI were used: 9 patients received atezolizumab (43%), 9 (43%) – pembrolizumab and 3 (14%) – nivolumab. The effect of therapy was evaluated according to imRECIST v.1.1. Factors of cell-mediated immunity were assessed by flow cytometry before treatment including immunotherapy. CD8+CD279+, CD4+CD279+, TLR2, TLR4, TLR3, TLR8 were studied. Results: Complete response was observed in 2 (9%) patients, partial response in 5 (24%), stabilization in 4 (19%) and progression in 8 (38%). In one patient the treatment was cancelled due to the development of immune-mediated complication (Guillain-Barre syndrome). The factors studied varied depending on different effect. In cases of LC stabilization/progression the initial amount of CD8+CD279+ cells were twice lower than in cases with complete/partial response. In the first group CD8+CD279+ cells` level before the treatment was 0,1-3,4%, while in the other group 4,1-9% (7,0±1,16%). In patients with stabilization/progression CD4+CD279+ cells` level before the immunotherapy was 0,1-3,3 and in patients with response to treatment 1,4-7,8% (3,4±0,8%) of total CD4+ lymphocytes. Besides, the LC patients with different effect of treatment had different initial amount of CD4+ Tem cells: stable response to CPI developed in patients with their higher levels (40,8±3,9%) vs 15,3±3,9% in cases of tumor progression (p < 0.05). Initial high expression of TLR2 and TLR4 as well as low expression of TLR3 and TLR8 on monocytes in patients with response to immunotherapy suggests the contribution of innate immunity to its effect. Conclusions: Complete or partial response should be expected in cases of initially high per cent of T lymphocytes (CD4+, CD8+) CD4+ Tem cells and TLR2+, TLR4+ as well as low amount of TLR3+ and TLR8+ monocytes. These factors should be studied in future as predictive factors for effectiveness of CPI.

Outcomes of BRAF mutant metastatic melanoma (MM) patients (pts) after cessation of targeted therapy (TT) with BRAF or BRAF/MEK inhibitor(i).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9564-9564
Author(s):  
Natalie Jackson ◽  
Theresa Rodgers ◽  
Ida John ◽  
Denai R. Milton ◽  
Lauren Elaine Haydu ◽  
...  
Keyword(s):  
Single Agent ◽  
Complete Response ◽  
Braf V600e ◽  
Response To Treatment ◽  
Cancer Center ◽  
Full Cohort ◽  
Time To Recurrence ◽  
Braf Mutant ◽  
Unacceptable Toxicity

9564 Background: Since their introduction into the clinic a decade ago, BRAF and BRAF/MEKi have dramatically changed the outcomes of pts with BRAF mutant MM. While typically, these agents are administered until progression (PD), other reasons for stopping TT include unacceptable toxicity, complete response to treatment, or pt/physician decision or preference. The outcomes for MM pts that stop TT for reasons other than PD are largely unknown. Here we report the clinical features and outcomes of the largest cohort of MM pts who stopped TT for reasons other than PD to date. Methods: Under an institutionally approved database, we identified MM pts treated at the MD Anderson Cancer Center with BRAF±MEK inhibitors, and their records were reviewed to identify pts that stopped TT for reasons other than PD. Pts demographics, treatment information and clinical outcomes were recorded. Overall survival (OS) time was computed from three start dates (initial diagnosis, initial unresectable stage III melanoma, 1st dose of TT) to last known vital sign. Pts alive at the last follow-up date were censored. Time to recurrence was computed from date of 1st dose of TT to recurrence. Pts who did not experience disease recurrence were censored The Kaplan-Meier method was used to estimate OS and time to recurrence. Results: A total of 58 pts were identified, 32 (55%) were male. Most pts had a BRAF V600E (n = 49) or V600K (n = 6) mutation. At TT initiation median age was 59.5 years (range 29- 95), LDH was within normal range in 46 (85%), median number of prior systemic therapies was 1 (range 0-5), with 50% of pts receiving prior systemic therapy. Most (n = 33; 57%) pts were treated with single agent BRAFi (12 with dabrafenib, 11 vemurafenib). Among pts treated with combination TT (n = 25), most received dabrafenib with trametinib (n = 21; 84%). Median TT treatment duration was 9.5 months (range 0.03-80.5 months). Reasons for TT discontinuation were unacceptable toxicity (n = 29; 50%) and pt or physician decision/preference in responding patients (n = 23; 40%). At time of TT discontinuation, 48% of pts had achieved a complete response (CR), 28% a partial response (PR), and 22% stable disease (SD), 1 patient had unknown disease status. With standard follow-up, after stopping TT, 40 pts (69%) have recurred or experienced PD, with a median time to recurrence of 14.9 months (95% CI:7.8-26.3 months). At PD, 32 (76%) of pts had new metastatic sites. After PD 26 pts (63%) pts received BRAF/MEKi, 11 (44%) achieved a CR and 6 (24%) a PR, and 5 (20%) for a response rate of 88%; while 3 (12%) pt had PD as best response and 1 was unknown. For the full cohort, the median OS from time of 1st dose of TT was 6.4 years. Conclusions: Among MM pts who stopped TT for reasons other than PD, the majority of pts recurred, but most responded to re-introduction of TT. This information can help to inform discussion with pts regarding cessation of, or re-challenge with, TT.

Rituximab in the Treatment of Adults with Chronic Idiopathic Thrombocytopenic Purpura (ITP) and Autoimmune Hemolytic Anemia (AIHA).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3930-3930 ◽  
Author(s):  
Ghassan Zalzaleh ◽  
Ahmad Jajeh ◽  
Diemante Tamoseviciene
Keyword(s):  
Partial Response ◽  
Hemolytic Anemia ◽  
Complete Response ◽  
Pure Red Cell Aplasia ◽  
Lymphocytic Leukemia ◽  
Overall Response ◽  
Medical Centers ◽  
History Of ◽  
Refractory Itp

Abstract Corticosteroids have been the first line of treatment of ITP since 1950, however some patients do not respond to this treatment (refractory) and some will relapse after its discontinuation. For such patients second line treatments were introduced. Some patients will continue to be refractory to this treatment and need other therapy modality. Rituximab is a chimeric monoclonal antibody directed against the CD20 antigen exposing B Lymphocytes, causing its depletion. This could alter the production of auto-antibodies in some Auto-Immune diseases and thus could be used in their treatment. Few medical centers had reported using Rituximab in the treatment of refractory (ITP) and (AIHA), yet its definite role could not be determined, and here we share our experience. Patients with documented diagnosis of ITP or AIHA who were refractory to at least two lines of therapy including steroids were offered to receive Rituximab (375mg/m2 weekly for 4 weeks). 15 patients were enrolled, 10 with ITP, 4 with AIHA, 1 with Coombs negative Hemolytic anemia, and 1 with pure red cell aplasia. One had both ITP and AIHA. 10 were females and 5 males. 5 were >60 years old and 10 were < 60 years old. 2 out of the 10 patients with ITP had also Chronic Lymphocytic Leukemia (CLL). Duration of follow up ranged from 2 months to 17 months (average 7 mos). Of the 10 patients with refractory ITP treated with Rituximab overall response was 60%. 4 were NR (no response), 2 were MR (minimal response: Platelets increased to <50000), 2 were PR (Partial response: Platelets increased to <100000) and 2 were complete response (Platelets became normal). 3 patients of 6 with Hemolytic anemia or PRC aplasia had NR, 1 had MR (Hct <30), and 2 had partial response (Hct 30–35). No complete response was observed in this group. In 3 patients with hemolytic anemia and CLL 1 had MR, 1 had PR and 1 had NR. 2 patients with hemolytic anemia who had NR died as a complication of their disease (one with septic shock and one with severe autoimmune flare up). Only one patient with refractory ITP had mild allergic side effects and did not complete 4 doses. No Rituximab related mortality was observed. CONCLUSION: Rituximab therapy had a variable but valuable effect in the treatment of patients with chronic refractory ITP and refractory/ relapsed AIHA. Overall response in our group reached 60%. No clinical or laboratory parameters were found to predict response, although there was a suggestion that males, younger age, and no history of splenectomy have a better chance of response. As we lack an effective alternative treatment in chronic refractory ITP and AIHA, Rituximab use could be a valid option in view of its mild toxicity. Further follow up of our patients and input from other institutions in this regard are needed.

Efficacy of Thalidomide in the Treatment of Severe Recurrent Epistaxis in Hereditary Hemorrhagic Telangiectasia (HHT): Preliminary Results of an Ongoing Study

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 629-629
Author(s):  
Carlo L Balduini ◽  
Francesca Bellistri ◽  
Fabio Pagella ◽  
Francesco Chu ◽  
Elina Matti ◽  
...  
Keyword(s):  
Partial Response ◽  
Severity Score ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Vascular Malformations ◽  
Complete Response ◽  
Open Label ◽  
Off Label ◽  
Preliminary Results ◽  
Recurrent Epistaxis

Abstract Abstract 629 Introduction. Hereditary hemorrhagic telangiectasia (HHT; OMIM 187300 and 600376), also known as Rendu-Osler-Weber syndrome, is an autosomal dominant disease that leads to multiregional angiodysplasia. It affects approximately one in 5000 people. Recurrent and severe epistaxis, due to the presence of telangiectasias in nasal mucosa, is the most common presentation of HHT, frequently leading to severe anemia requiring iron supplements and blood transfusions. Multiple approaches, including surgical options, have been tried In the management of HHT epistaxis, but all of them are largely palliative with variable and temporary results. As a consequence, most patients require repeated interventions. Recently, angiogenesis has been implicated in the pathogenesis of HHT and, therefore, it has been suggested that anti-angiogenic substances may be effective in the treatment of vascular malformations. A recent study (Nat Med 2010; 16:420–428) found that oral administration of 100 mg of thalidomide daily lowered the frequency of epistaxis in six of seven treated subjects. The aim of our prospective, non-randomized, phase II, open-label trial is to confirm the effectiveness of this drug in reducing epistaxis and to identify the lowest effective dose in patients with HHT refractory to standard therapy (ClinicalTrials.gov Identifier: NCT01485224). Methods. HHT patients with at least one episode of overt bleeding/week requiring at least one blood transfusion during the last three months and refractory to mini-invasive surgical procedures are enrolled. Thalidomide is administered at a starting dose of 50 mg/day orally. In the event of no response, thalidomide dosage is increased by 50 mg/day every 4 weeks until complete (cessation of nose bleeding) or partial response (reduction in the severity of epistaxis less than complete response) to a maximum dose of 200 mg/day. After the achievement of complete/partial response patients are treated for 16 additional weeks. Monthly follow-up evaluates the epistaxis severity score and the transfusion need, with adverse events being reported. The study, which wants to enroll 34 patients, is currently recruiting participants. Results. Eleven patients, 7 M and 4 F, aged 45–80 years (median 67), with mutations in either ACVRL1 (8 cases) or ENG gene (3 cases) have been enrolled so far and 5 have completed at least 16 weeks of treatment (median follow-up 11 weeks, range 1–28). Treatment was effective in all 9 evaluable patients. Five patients responded within 4 weeks of starting the drug: cessation of nose bleeding was observed in one case, and a large reduction of nose bleeding measured according to a well defined epistaxis severity score (Am J Rhinol Allergy 2009;23:52–58) has been obtained in 4 cases. Four patients achieved a good, partial response after 8 weeks of treatment. As a consequence, thalidomide therapy significantly increased hemoglobin levels and abolished or greatly decreased the need for red blood cell transfusions. Only nonserious, drug-related adverse effects were observed during treatment, including constipation and drowsiness. Three patients completed the treatment and remained stable, off of thalidomide, without the loss of response during the immediate follow-up period. Conclusions. These preliminary results strongly support the hypothesis that low-dose thalidomide is very effective for the treatment of epistaxis in patients with severe HHT who did not benefit from other available modalities of treatment. Disclosures: Off Label Use: Thalidomide is used off-label for tretment of hereditary hemorrhagic telangiectasia.

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