Autologous stem cell transplant for immunoglobulin light chain amyloidosis: a status report.
High-dose chemotherapy for the management of immunoglobulin light chain amyloidosis remains an effective and viable treatment technique for selected patients with this disorder. We reviewed the medical records of 434 patients uniformly treated with high-dose chemotherapy and autologous stem cell transplant at Mayo Clinic, Rochester, Minnesota, between 8 March 1996 and 13 April 2010. Outcomes, engraftment, and predictors of early mortality were reviewed. Median survival has not been reached for the patients with a complete response, is 107 months for those with a partial response, and is 32 months for patients with no response (p < 0.001). The only predictor of survival was cardiac stage (p  < 0.001). The hematologic response rate is predictive for organ response rates. Both hematologic and organ responses are associated with improved survival.
Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA. gertz.morie@mayo.edu
Morie A
MA
Gertz
Martha Q
MQ
Lacy
Angela
A
Dispenzieri
Suzanne R
SR
Hayman
Shaji K
SK
Kumar
David
D
Dingli
Stephen M
SM
Ansell
Dennis A
DA
Gastineau
David J
DJ
Inwards
Patrick B
PB
Johnston
Mark R
MR
Litzow
Ivana N M
IN
Micallef
Luis F
LF
Porrata
Nelson
N
Leung
William J
WJ
Hogan
Francis K
FK
Buadi
D000686:Amyloidosis / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D007147:Immunoglobulin Light Chains