Improvement in quality of life of patients with AL amyloidosis treated with high-dose melphalan and autologous stem cell transplantation.
Treatment of AL amyloidosis patients with high-dose melphalan chemotherapy followed by autologous peripheral blood stem cell transplantation (HDM/SCT) can produce hematologic complete responses (CRs) and improvement in organ function. To determine whether these responses are accompanied by improvement in quality of life (QOL), we employed the Medical Outcomes Study (MOS) 36-item Short Form General Health Survey (SF-36) questionnaire for 544 patients evaluated between 1994 and 2002. At baseline, the scores were significantly lower on all 8 SF-36 scales compared with age-matched population norms: the composite physical component summary (PCS) for the AL patients was 34.5 versus the population norm of 46.8, and the mental component summary (MCS) was 45.0 versus the norm of 51.5. All SF-36 scores improved at 1 year, with the MCS reaching the population norm. The PCS, though improved, was still lower than normal but was greater in the subgroup of patients who achieved a hematologic CR; the PCS normalized at 2 years in these patients. Thus, treatment of AL amyloidosis patients with HDM/SCT produces measurable and sustained improvements in quality of life, particularly in those patients who achieve hematologic CR.
Seldin
David C
DC
Amyloid Treatment and Research Program, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. dseldin@bumc.bu.edu
Anderson
Jennifer J
JJ
Sanchorawala
Vaishali
V
Malek
Karim
K
Wright
Daniel G
DG
Quillen
Karen
K
Finn
Kathleen T
KT
Berk
John L
JL
Dember
Laura M
LM
Falk
Rodney H
RH
Skinner
Martha
M
D000686:Amyloidosis / Q000188:drug therapy* / Q000601:surgery*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage* / Q000627:therapeutic use*; D008875:Middle Aged; D011788:Quality of Life; D033581:Stem Cell Transplantation; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome
D008558:Melphalan