BACKGROUND: The use of thalidomide during the 1950s resulted in teratogenic 
effects in thousands of infants. Although thalidomide is currently approved for 
the treatment of a complication of leprosy, it is commercially available to 
treat other diseases through a controlled distribution system. This article 
presents a summary of a scientific conference organized to assess clinical 
research on thalidomide, its new clinical applications, and the social and 
ethical implications for its use.
METHODS: Summaries of 10 presentations and two panel discussions were developed 
from the authors's, oral presentations, conference slides, responses to 
questions, and supporting literature.
RESULTS: Thalidomide shows promise in treating several diseases, including 
HIV/AIDS, rheumatoid arthritis, Crohn's disease, and multiple myeloma. The 
STEPStrade mark (System for Thalidomide Education and Prescribing Safety) 
Program has been developed by Celgene, the commercial manufacturer of 
thalidomide, to ensure compliance with prescription and usage protocols. A 
surveillance system is also in place to monitor and report compliance patterns.
CONCLUSIONS: Despite the tragic past associated with thalidomide, the drug shows 
promise as a treatment for many clinical disorders. The challenge is to answer 
lingering questions of risks and benefits through clinical trials and discovery, 
to monitor participation and compliance with protocols developed to avoid use of 
the drug during pregnancy, and to continue to search for safer and more 
effective treatment options.