Details

Autor(en) / Beteiligte

• Hayashi, Toshiaki
• Ikeda, Hiroshi
• Igarashi, Tetsuyuki
• Maruyama, Yumiko
• Aoki, Yuka
• Nojima, Masanori
• Ishida, Tadao
• Shinomura, Yasuhisa

Titel

Autologous stem cell transplantation for AL amyloidosis: adjustment of melphalan dose by factors including BNP

Ist Teil von

• International journal of hematology, 2014-12, Vol.100 (6), p.554-558

Ort / Verlag

Tokyo: Springer Japan

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• High-dose melphalan with autologous stem cell transplantation (HDM/ASCT) is a promising treatment option for eligible patients with systemic immunoglobulin light chain (AL) amyloidosis. We present the results of ASCT following risk-adapted melphalan conditioning on the basis of criteria proposed by our group, including B-type natriuretic peptide (BNP). Ten patients with primary systemic AL amyloidosis treated at our institute were evaluated. A full dose of melphalan (200 mg/m 2 ) was administered to patients who met all the following: performance status, 0 or 1; number of organs involved, 2 or less; serum creatinine, 1.5 mg/dL or less; EF 50 % or more and BNP 200 pg/mL or less; otherwise 140 mg/m 2 . The hematologic complete response was achieved in four and organ response was seen in two patients. The median event-free survival (EFS) of all patients was 21.5 months, and median overall survival (OS) was 47.0 months. EFS and OS were significantly longer for patients who received 200 mg/m 2 of melphalan than for those who received lower dose (EFS: not reached vs. 13.9 months, P  = 0.0217; OS: not reached vs. 13.8 months, P  = 0.0186). No treatment-related mortality within 100 days from ASCT was observed. Evaluation of cardiac diastolic function may contribute to safer HDM/ASCT and improve outcome of AL amyloidosis.