Successful reduced intensity allogeneic stem cell transplantation for systemic AL amyloidosis.
No established treatments for systemic AL amyloidosis have been determined, and only four reports have described allogeneic stem cell transplantation for this disease. We report the case of a patient with orthostatic hypotension, diarrhea, nephrotic syndrome, and cardiac amyloidosis due to systemic AL amyloidosis. Reduced intensity allogeneic stem cell transplantation (RIST) was performed using a conditioning regimen comprising fludarabine 125 mg/m2 and melphalan 90 mg/m2. Hematologically complete remission and symptomatic improvement were obtained without severe transplantation-related complications. RIST may thus offer a useful treatment strategy for systemic AL amyloidosis complicated by cardiac amyloidosis.
Imamura
Tomoyuki
T
Division of Pathogenesis and Disease Control, Department of Infectious Diseases, Oita, Japan. tomo3jo@oct-net.ne.jp
Ogata
Masao
M
Kohno
Kazuhiro
K
Tomo
Tadashi
T
Ohtsuka
Eiichi
E
Kikuchi
Hiroshi
H
Kadota
Jun-ichi
J
D000328:Adult; D000686:Amyloidosis / Q000097:blood / Q000473:pathology / Q000628:therapy*; D003967:Diarrhea / Q000097:blood / Q000473:pathology / Q000628:therapy; D004359:Drug Therapy, Combination; D006331:Heart Diseases / Q000097:blood / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000473:pathology / Q000628:therapy; D007564:Japan; D007674:Kidney Diseases / Q000097:blood / Q000473:pathology / Q000628:therapy; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D019653:Myeloablative Agonists / Q000008:administration & dosage*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D019653:Myeloablative Agonists; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan