Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994-2009

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

High-dose melphalan and autologous stem cell transplantation (HDM/ASCT) is widely used in immunoglobulin light chain (AL) amyloidosis, but the benefit is debated mainly because of the high treatment-related mortality (24% in a randomised study comparing HDM/ASCT with oral melphalan/dexamethasone). We report here on the long-term outcome of all patients treated with HDM/ASCT for AL amyloidosis in Sweden between 1994 and 2009. Seventy-two patients were treated at eight Swedish centres. Median follow-up was 67.5 months. At least partial response (organ or haematological) was seen in 64% of the patients. Median overall survival was 98 months or 8.2 years, with 5-year survival 63.9% and 10-year survival 43.4%. In patients with cardiac involvement or multiple organ involvement, survival was significantly shorter, median overall survival 49 and 56 months, respectively. All mortality within 100 days from ASCT was 12.5% for all patients and 17.2% in the patients with cardiac involvement. For patients treated in the earlier time period (1994-2001), 100-day mortality was 23.8% compared with 7.8% in the later period (2002-2009). In conclusion, long survival times can be achieved in patients with AL amyloidosis treated with HDM/ASCT, also in smaller centres. Early mortality is high, but with a decreasing trend over time.

Detaljer

Författare
  • S. Rosengren
  • U. H. Mellqvist
  • H. Nahi
  • K. Forsberg
  • S. Lenhoff
  • O. Strömberg
  • L. Ahlberg
  • O. Linder
  • K. Carlson
Externa organisationer
  • Uppsala University Hospital
  • Karolinska Institute
  • Norrland University Hospital
  • Skåne University Hospital
  • Linköping University Hospital
  • Örebro University Hospital
  • South Elfsborg Hospital
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hematologi
Originalspråkengelska
Sidor (från-till)1569-1572
Antal sidor4
TidskriftBone Marrow Transplantation
Volym51
Utgivningsnummer12
StatusPublished - 2016 dec 1
PublikationskategoriForskning
Peer review utfördJa
Externt publiceradJa