IgM AL amyloidosis due to B cell lymphoproliferative disorder: efficacy of high-dose melphalan followed by autologous stem cell transplantation.
This report concerns a patient with IgM AL amyloidosis due to a B cell lymphoproliferative disorder who was successfully treated with VAD and subsequent high-dose melphalan followed by autologous stem cell support. After this chemotherapeutic regimen, the patient showed complete hematological remission and improvement in nephrotic syndrome. These findings suggest that high-dose melphalan may also be effective for lymphoplasmacytoid cells producing monoclonal IgM which are phenotypically distinct from plasma cells. Myeloablative therapies, such as high-dose melphalan, should definitely be considered as a treatment option for AL amyloidosis, irrespective of the type of precursor immunoglobulin.
Third Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Takahisa
T
Gono
Masayuki
M
Matsuda
Yasuhiro
Y
Shimojima
Wataru
W
Ishii
Kanji
K
Yamamoto
Jun
J
Koyama
Kazuo
K
Sakashita
Kenichi
K
Koike
Susumu
S
Itoh
Toshifumi
T
Isaka
Shu-ichi
S
Ikeda
D000686:Amyloidosis / Q000150:complications / Q000628:therapy*; D001402:B-Lymphocytes / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000276:immunology / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
D007075:Immunoglobulin M; D008558:Melphalan