Effectiveness of bortezomib in cardiac Al amyloidosis: a report of two cases.
Cardiac involvement is a major prognostic determinant in patients with primary AL amyloidosis. The clinical results of standard therapeutic approaches are suboptimal. It has been recently shown that bortezomib, an inhibitor of the proteasome, can induce rapid favourable responses in AL amyloidosis improving cardiac function and survival. Herein we report on two patients with cardiac amyloidosis treated by bortezomib who experienced partial or total remission of hematologic disease and of cardiac involvement. However, death of one patient, suffering from chronic kidney disease stage 5, due to fulminant respiratory syndrome suggests the need for caution in bortezomib use if patients have this comorbid condition.
Department of Medicine, Nephrology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy.
Santi
S
Nigrelli
Hematology and Transfusional Service, St. M. Annunziata Hospital, ASL 10, Florence, Italy.
Giuseppe
G
Curciarello
Cardiology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy.
Piercarlo
P
Ballo
Department of Medicine, Nephrology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy.
Stefano
S
Michelassi
Department of Medicine, Nephrology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy.
Francesco
F
Pizzarelli