Document Detail


Autologous transplantation for primary systemic AL amyloidosis is feasible outside a major amyloidosis referral centre: the Calgary BMT Program experience.
MedLine Citation:
PMID:  16062177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent reports from large amyloidosis referral centers suggest that primary systemic AL amyloidosis patients treated with high-dose melphalan (HDM) and autologous stem cell transplantation (ASCT) survive longer than historical controls treated with less intensive chemotherapy, despite high transplant-related mortality (TRM) rates of >10%. A retrospective review was conducted to determine if the outcome of ASCT for AL amyloidosis at our institution was similar to that reported at major amyloidosis referral centers. Over a 7 year period, we treated a total of 15 AL amyloidosis patients with ASCT, including four with poor prognosis cardiac or multisystem involvement. No TRM was observed. Overall, 10 patients (67%) achieved a complete hematological response and four patients (27%) achieved a complete organ response. The 4-year event-free and overall survival rates were 60% (95% CI 32-89%) and 75% (95% CI 50-100%), respectively. One patient, who presented with cardiac failure and multiorgan involvement with colonic bleeding currently remains in complete remission 62 months post-ASCT. In conclusion, ASCT for primary AL amyloidosis can safely be performed at experienced transplant centers that are not associated with major amyloidosis referral centers, and is feasible for patients who have multisystem involvement, particularly for motivated patients with good performance status.
Authors:
L Q M Chow; N Bahlis; J Russell; A Chaudhry; D Morris; C Brown; D A Stewart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  36     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-15     Completed Date:  2005-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  591-6     Citation Subset:  IM    
Affiliation:
Departments of Medicine and Oncology, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amyloid / chemistry
Amyloidosis / therapy*
Antigens, CD34 / biosynthesis
Antineoplastic Agents / pharmacology
Biopsy
Bone Marrow Transplantation / methods*
Disease-Free Survival
Female
Hematopoietic Stem Cell Mobilization
Humans
Male
Middle Aged
Prognosis
Remission Induction
Retrospective Studies
Risk
Time Factors
Transplantation, Autologous / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Amyloid; 0/Antigens, CD34; 0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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