Why is thalidomide a current drug on the market?

Question

Given the thalidomide birth defect disaster of the 1960s, why was it later approved by the U.S. FDA for treatment of leprosy (1996) and of multiple myeloma (2006)? Presumably, the teratogenic issues and problems with permanent nerve damage didn't go away, as the liver can convert the "good" enantiomer to the "bad." Thalidomide affects even non-pregnant women, so why approve a drug with known severe complications?

Answer 1

It is a proteosome inhibitor used in Multiple Myeloma treatments, usually patients with this disorder are older and out of the range of negative fetal side effects.