Resolution of heart failure in patients with AL amyloidosis.
BACKGROUND
Patients with AL amyloidosis and congestive heart failure have a very poor prognosis. To date, the recovery of these patients has not been described in detail.


OBJECTIVE
To determine the frequency and characteristics regression of disease in patients with congestive heart failure due to AL amyloidosis.


METHODS
Review of patients with systemic AL amyloidosis.


METHODS
An international referral center for amyloidosis in the United States.


METHODS
140 patients with congestive heart failure due to Al amyloidosis who were seen between 1983 and 1994.


METHODS
Functional status, Doppler echocardiography, and objective measurements of disease activity.


RESULTS
3 of 140 patients (2.1%) had marked resolution of congestive heart failure and evidence for remission of disease activity. All 3 had been treated with melphalan.


CONCLUSIONS
Melphalan appears to have had a favorable effect in 3 patients with AL amyloidosis and heart failure. The abolition of light chains that was seen in these 3 patients suggests that light-chain toxicity may play a role in the genesis of heart failure in patients with AL amyloidosis.
Dubrey
S
S
Boston University School of Medicine, Massachusetts, USA.
Mendes
L
L
Skinner
M
M
Falk
R H
RH
D000686:Amyloidosis / Q000150:complications*; D003078:Colchicine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D012074:Remission Induction
D008558:Melphalan; D003078:Colchicine