title: Bortezomib, melphalan, and prednisolone combination chemotherapy for newly diagnosed light chain (AL) amyloidosis.
abstract: Bortezomib combination chemotherapy appears to be active in light chain (AL) amyloidosis with high rates of hematologic and organ response. We report a retrospective evaluation of the clinical outcome of treatment with bortezomib, melphalan, and prednisolone (VMP) as first-line chemotherapy in patients with AL amyloidosis who were ineligible for autologous stem cell transplant. Among the 19 patients included in this study, 90% had two or more involved organs and most of the patients had advanced stage AL amyloidosis (84% with 2004 Mayo Stage III and 92% with 2012 Mayo Stage III or IV). Sixteen (84%) patients had a hematologic response, including seven (37%) with complete response, with time to response of 1-3 months. Cardiac and renal responses were observed in 44% and 33% of patients, respectively. Estimated 2-year survival is 39%, and 5 patients (26%) died during therapy. The common grade 3-4 adverse events were thrombocytopenia, diarrhea and pneumonia. A once-weekly bortezomib is more feasible than twice-weekly regimen. Our results suggest that triplet regimen of VMP appears to be an effective regimen in advanced AL amyloidosis ,but benefits in the patients with multi-organ dysfunction remain to be proven.
authors.affiliation: Department of Medicine .
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Lee
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Lim
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Ga Yeon
authors.initials: GY
authors.lastname: Lee
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Choi
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Lee
authors.forename: Ju-Hong
authors.initials: JH
authors.lastname: Min
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Jeon
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000188:drug therapy*; D001897:Boronic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D000069286:Bortezomib; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011719:Pyrazines / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D011239:Prednisolone; D008558:Melphalan
keywords: Amyloidosis; bortezomib; light chain