After nearly decades of extinction as a sedative and antiemetic, thalidomide 
reemerged as the parent compound of a novel and promising class of therapeutics 
termed the immunomodulatory drugs (IMiDs). The analogues of thalidomide, CC-5013 
(lenalidomide, Revlimid) and CC-4047 (Actimid) are more potent regulators of 
cellular immune and cytokine response while lacking some of the dose limiting 
side effects of the parent compound, such as neurologic toxicity. Preclinical 
data will be reviewed that outlines these drugs' effects on tumor necrosis 
alpha, interleukin 12, angiogenesis, and T-cell function. The evolution of the 
use of thalidomide as a therapeutic for diseases such as multiple myeloma and 
myelodysplastic syndrome and the promising initial results of the new IMiDs will 
be reviewed.