Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin Lymphoma Myeloma Leuk. 2014 Oct;14(5):424-430.e1. doi: 10.1016/j.clml.2014.02.003. Epub 2014 Feb 16.

Induction bortezomib in Al amyloidosis followed by high dose melphalan and autologous stem cell transplantation: a single institution retrospective study.

Author information

1
Center for Hematologic Malignancies, Oregon Health and Science University Knight Cancer Institute, Portland, OR. Electronic address: scottem@ohsu.edu.
2
Oregon Health and Science University Knight Cardiovascular Institute, Portland, OR.
3
Center for Hematologic Malignancies, Oregon Health and Science University Knight Cancer Institute, Portland, OR.

Abstract

INTRODUCTION/BACKGROUND:

High-dose melphalan (HDM) followed by autologous stem cell transplant (ASCT) for light chain amyloidosis (AL) was performed in 31 patients at Oregon Health and Science University between 2005 and 2012. Fifteen patients had cardiac involvement.

PATIENTS AND METHODS:

Patients received melphalan 200 mg/m(2) or dose-adjusted HDM (100-140 mg/m(2)) depending on high risk features. Thirteen patients proceeded directly to ASCT after diagnosis, 12 patients received a bortezomib-containing regimen, and 6 received a variety of other induction regimens.

RESULTS:

The day 100 treatment-related mortality was 9.6%. Overall hematologic (ORR) and organ response rates (OR) in the whole cohort after ASCT were 77% and 58%. ORR and OR in the bortezomib pretreated group were 92% and 75% vs. 69% and 54% in the group that received no pretreatment. The median time to maximum hematologic response after ASCT was reduced in the group that received bortezomib induction (3 vs. 14 months). Overall cardiac response rate was 60%; 100% in patients pretreated with bortezomib and 43% in those without induction treatment. With a median follow-up of 2.9 years, the 3-year progression-free and overall survival rates in the entire cohort were 66% and 73% and in those with cardiac involvement, 73% and 80%.

CONCLUSION:

We observed that bortezomib-based induction is well tolerated in patients with and without cardiac involvement and suggest that this approach be studied in prospective multi-institutional trials.

KEYWORDS:

Amyloid; Bortezomib induction; Stem cell transplantation

PMID:
24650974
DOI:
10.1016/j.clml.2014.02.003
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center