© 2003 European Society for Medical Oncology

Severe hepatic toxicity due to thalidomide in relapsed multiple myeloma Thalidomide has shown efficacy in the treatment of advanced refractory multiple myeloma even after autologous stem-cell transplantation [1] and has been evaluated alone or in com-bination in the treatment of various solid and hematological malignancies [2–4]. Both antiangiogenic activity [5] and the immunomodulatory properties of thalidomide are proposed mechanisms for its beneficial effects [6]. Common side-effects during treatment with thalidomide are sedation, constipation, skin rash and peripheral neuropathy. Less frequently brady-cardia, hypotension and hypothyroidism have been described [7]. However, life-threatening toxicity due to thalidomide has occurred as toxic epidermal necrolysis [1], and in combinatio