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- Title
Treatment With Bortezomib-based Therapy, Followed by Autologous Stem Cell Transplantation, Improves Outcomes in Light Chain Amyloidosis: A Retrospective Study.
- Authors
Jain, Tania; Kosiorek, Heidi E.; Kung, Shu T.; Shah, Vishal S.; Dueck, Amylou C.; Gonzalez-Calle, Veronica; Luft, Susan; Reeder, Craig B.; Adams, Roberta; Noel, Pierre; Larsen, Jeremy T.; Mikhael, Joseph; Bergsagel, Leif; Stewart, A. Keith; Fonseca, Rafael
- Abstract
<bold>Background: </bold>The hematologic response is critical in patients with light chain amyloidosis because a good response is known to improve organ response and overall survival. We present a retrospective analysis to compare the hematologic and organ response in patients who received bortezomib-based therapy before autologous stem cell transplantation (ASCT) versus those who received non-bortezomib-based therapy before ASCT and those who underwent ASCT at diagnosis.<bold>Patients and Methods: </bold>Of a total of 63 patients who underwent ASCT for light chain amyloidosis, 34 received bortezomib-based therapy before ASCT (Bor-ASCT) and 29 did not receive bortezomib therapy (non-Bor-ASCT). A greater number of patients had involvement of ≥ 3 organs and cardiac involvement in the Bor-ASCT group, suggesting a greater risk at baseline in the Bor-ASCT group.<bold>Results: </bold>At 3, 6, and 12 months after ASCT, the hematologic response was better in the Bor-ASCT group, with a statistically significance difference at 6 months (partial response or better in 82% vs. 20%; P = .002) and 12 months (partial response or better in 76% vs. 33%; P = .02). Organ responses (66% vs. 21%; P < .001) and median overall survival (not reached vs. 53 months; P = .001) were also greater in the Bor-ASCT group.<bold>Conclusion: </bold>Our study has shown that bortezomib-based therapy before ASCT improves the hematologic response, organ response and overall survival, potentially by decreasing the light chain load before ASCT.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2018, Vol 18, Issue 7, p486
- ISSN
2152-2650
- Publication type
Academic Journal
- DOI
10.1016/j.clml.2018.04.006