title: Effective and well tolerated treatment with melphalan and dexamethasone for primary systemic AL amyloidosis with cardiac involvement.
abstract: 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.
authors.affiliation: Internal Medicine (Hematology/Oncology), Tokyo Medical University.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: YOSHIZAWA
authors.forename: Daigo
authors.initials: D
authors.lastname: AKAHANE
authors.forename: Hiroaki
authors.initials: H
authors.lastname: FUJIMOTO
authors.forename: Moritaka
authors.initials: M
authors.lastname: GOTOH
authors.forename: Toru
authors.initials: T
authors.lastname: KIGUCHI
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: TAUCHI
authors.forename: Kazuma
authors.initials: K
authors.lastname: OHYASHIKI
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020107:Troponin T; D003907:Dexamethasone; D008558:Melphalan