Effective and well tolerated treatment with melphalan and dexamethasone for primary systemic AL amyloidosis with cardiac involvement.
A 60-year-old woman was admitted with acute heart failure and was diagnosed as having primary systemic AL amyloidosis with cardiac involvement by endomyocardial biopsy. Electrophoresis revealed an IgG-lambda monoclonal component and amyloidosis was evident in the gastric and rectal mucosa. Her cardiac function at diagnosis was poor, including an ejection fraction of 59% and IVS of 19 mm, and serum cardiac troponin T (cTnT) was elevated (0.12 ng/ml). She was treated with melphalan-dexamethasone (Mel-Dex) therapy once a month. After more than a year, cardiac function and performance status were maintained, with decreasing levels of cTnT, indicating that Mel-Dex represents a feasible and effective therapeutic option for patients with AL amyloidosis with cardiac dysfunction.
YOSHIZAWA
Seiichiro
S
Internal Medicine (Hematology/Oncology), Tokyo Medical University.
AKAHANE
Daigo
D
FUJIMOTO
Hiroaki
H
GOTOH
Moritaka
M
KIGUCHI
Toru
T
TAUCHI
Tetsuzo
T
OHYASHIKI
Kazuma
K
D000208:Acute Disease; D000686:Amyloidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D020107:Troponin T; D003907:Dexamethasone; D008558:Melphalan