Predictors of survival in patients with systemic light-chain amyloidosis and cardiac involvement initially ineligible for stem cell transplantation and treated with oral melphalan and dexamethasone

D. Lebovic, J. Hoffman, B. M. Levine, H. Hassoun, H. Landau, Y. Goldsmith, M. S. Maurer, R. M. Steingart, A. D. Cohen, R. L. Comenzo

Research output: Contribution to journalArticle

99 Scopus citations

Abstract

The treatment of systemic light-chain (AL) amyloidosis with symptomatic cardiac involvement at diagnosis remains a challenge. We report the results of 40 consecutive newly diagnosed AL cardiac patients who were not candidates for stem cell transplant and therefore received monthly oral melphalan and dexamethasone. Median survival was 10.5 months and baseline predictors of survival included gender, troponin I and interventricular septal thickness. The most significant predictor of survival was response to therapy. The haematological response rate was 58% (23/40) with 13% (5/40) complete responses; most responses were noted in <3 cycles. Achievement of a rapid response to therapy extends survival.

Original languageEnglish (US)
Pages (from-to)369-373
Number of pages5
JournalBritish Journal of Haematology
Volume143
Issue number3
DOIs
StatePublished - Nov 2008

Keywords

  • Amyloidosis
  • Immunoglobulin light chains
  • Melphalan

ASJC Scopus subject areas

  • Hematology

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