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Cyclophosphamide, Thalidomide and Dexamethasone (CTD) Infoguide

This Infoguide provides information about cyclophosphamide, thalidomide and dexamethasone (CTD), one of the treatment combinations used in AL amyloidosis.

This Infoguide provides information about cyclophosphamide, thalidomide and dexamethasone (CTD), one of the treatment combinations used in AL amyloidosis. It aims to:

  • Provide you with more information about CTD as a treatment for AL amyloidosis
  • Answer some of the questions you may have about CTD
  • Help you to make informed decisions about the treatment options available to you

CTD is an oral (tablet form) combination treatment for AL amyloidosis.

It is often referred to as ‘chemotherapy’ or ‘chemo’, but it is actually a combination of three different drugs:

  • Cyclophosphamide (a chemotherapy drug)
  • Thalidomide (an immunomodulatory drug)
  • Dexamethasone (a steroid)

These three drugs have different but synergistic and complementary mechanisms of action. This means that they work
in different ways, but when used together, they are more effective at killing abnormal plasma cells in the bone marrow than when they are given alone.

Thalidomide is an immunomodulatory drug (IMiD). This means that it works by modifying the immune system. The main function of the immune system is to protect the body against disease and infection. Thalidomide is given orally (in tablet form) daily throughout the cycle, whether you are on a three-week or four-week CTD cycle.

As with all drugs, both cyclophosphamide and thalidomide have a number of possible side-effects, described in this infosheet. These vary considerably from patient to patient: what might be mild in one person can be more serious in another.

Dexamethasone is a synthetic steroid which acts like a naturally occurring hormone produced in the body. Dexamethasone is usually given orally when used in the CTD combination but, in other circumstances, it may be given
intravenously.

Side-effects vary considerably from patient to patient but most are temporary and usually resolve when dexamethasone doses are reduced or stopped.

Finally this infosheet also covers the different trials that are taking place to find more effective treatments for AL amyloidosis.