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Bortezomib and dexamethasone consolidation following risk-adapted melphalan and stem cell transplantation for patients with newly diagnosed light chain amyloidosis.
MedLine Citation:
PMID:  23014566     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
To improve the efficacy of risk-adapted melphalan in patients with AL amyloidosis, we conducted a phase II trial using bortezomib and dexamethasone (BD) as consolidation. Forty untreated patients with renal (70%), cardiac (65%), liver/GI (15%) or nervous system (13%) AL were assigned melphalan 100, 140 or 200 mg/m2 based on age, renal function and cardiac involvement. Hematologic response was assessed at 3 months post-SCT; patients with less than CR received BD consolidation. Four patients with advanced cardiac AL died within 100 days of SCT (10% TRM). Survival at 12 and 24 months post treatment start was 88 and 82% overall and was 81 and 72% in patients with cardiac AL. At 3 months post-SCT, 45% had  PR including 27% CR. Twenty-three patients received consolidation and in 86% response improved; all patients responded in one cycle. At 12 and 24 months, 79 and 60% had  PR, 58 and 40% CR. Organ responses occurred in 55 and 70% at 12 and 24 months. Eight patients relapsed/progressed. One patient with serologic progression had organ impairment at time of progression. In newly diagnosed AL, BD following SCT rapidly and effectively improves responses resulting in high CR rates and maintained organ improvement.Leukemia accepted article preview online, 27 September 2012; doi:10.1038/leu.2012.274.
Authors:
H Landau; H Hassoun; M A Rosenzweig; M Maurer; J Liu; C Flombaum; C Bello; E Hoover; E Riedel; S Giralt; R L Comenzo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-27
Journal Detail:
Title:  Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K     Volume:  -     ISSN:  1476-5551     ISO Abbreviation:  Leukemia     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704895     Medline TA:  Leukemia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Memorial Sloan-Kettering Cancer Center, New York, NY, USA [2] Weill Cornell Medical College, New York, NY, USA.
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