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Among the patients with pneumococcal meningitis, 26 percent in the dexamethasone group had an unfavorable outcome, as compared with 52 percent in the placebo group.

Only the two late deaths (due to lung cancer and gastric cancer) in the group assigned to receive melphalan plus dexamethasone were not directly related to amyloidosis or to the treatments received.

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However, given the remarkable antimyeloma activity of lenalidomide, overall improved toxicity profile of lenalidomide compared with thalidomide and a need for improved treatments for this incurable malignancy, the combinations of lenalidomide are worthy of study.

Prolonged intravenous dexamethasone treatment of patients with mild disease was not considered acceptable.

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Patients on enzyme inducing drugs eg anti-convulsants and rifampicin, may rapidly metabolise dexamethasone and give a false positive result ie no suppression.

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