AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patient Population
2.2. FISH Abnormalities
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Hematological/Organ Response and Survival/Prognosis Outcomes
3.3. Toxicity Profiles in the Maintenance Group
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | All Patients (n = 50) | No Maintenance Therapy (n = 22) | Maintenance Therapy (n = 28) | p-Value |
---|---|---|---|---|
Median age at diagnosis (range), years | 58 (33–71) | 58 (33–71) | 58 (39–70) | 0.990 |
Gender, male, n (%) | 33 (66.0) | 15 (68.2) | 18 (64.3) | 0.773 |
Specific induction regimen received, n (%) | Lenalidomide–dexamethasone 5 (10%) Melphalan–prednisone 4 (8%) Bortezomib–dexamethasone 15 (30%) Bortezomib–lenalidomide–dexamethasone 2 (4%) Cyclophosphamide–bortezomib–dexamethasone 14 (28%) None 10 (20%) | |||
Specific maintenance therapy used, n (%) Immunomodulator (lenalidomide, thalidomide), bortezomib | 0 (0) 0 (0) | 24 (86) 4(14) | ||
Melphalan dose received, 140 mg/m2 200 mg/m2 | 23 (46.0) 27 (54.0) | 11 (50.0) 11 (50.0) | 12 (42.9) 16 (57.1) | 0.620 |
Light chain restriction (kappa) | 14 (28) | 4 (18.2) | 10 (35.7) | 0.215 |
Light chain restriction (lambda) | 35 (70) | 18 (81.8) | 17 (60.7) | 0.131 |
dFLC mg/dla median (range) | 17.9 (1209–7001) | 15.9 (300–607) | 25 (1209–7001) | 0.640 |
BMPCb <10% ≥10% | 24 (48%) 26 (52%) | 16 (72.7) 6 (27.3) | 8 (28.6) 20 (71.4) | 0.004 |
Urine total protein, mg/24 h, median (range) | 6849 (0–81,921) | 10,308 (0–81,921) | 3758 (0–22,500) | 0.06 |
No. of involved organs, median (range) | 2 (0–5) | 1 (0–4) | 2 (1–5) | 0.910 |
Cardiac involvement, n (%) | 18 (36.0) | 10 (45.5) | 8 (28.6) | 0.217 |
Renal involvement, n (%) | 40 (80.0) | 19 (86.4) | 21 (75.0) | 0.319 |
NT-proBNP ≥ 332 ng/L, n (%) | 19 (70.4) | 8 (72.7) | 11 (68.8) | 0.824 |
NT-proBNP ≥ 1800 ng/L, n (%) | 11 (40.7) | 6 (54.5) | 5 (31.3) | 0.226 |
Mayo stage (2012), n (%) | 0.460 | |||
I | 13 (50.0) | 5 (50.0) | 8 (50.0) | |
II | 7 (26.9) | 4 (40.0) | 3 (18.8) | |
III | 2 (7.7) | 0 (0.0) | 2 (12.5) | |
IV | 4 (15.4) | 1 (10.0) | 3 (18.8) | |
Missing | 24 | 12 | 12 |
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Ozga, M.; Zhao, Q.; Benson, D.; Elder, P.; Williams, N.; Bumma, N.; Rosko, A.; Chaudhry, M.; Khan, A.; Devarakonda, S.; et al. AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes. J. Clin. Med. 2020, 9, 3778. https://doi.org/10.3390/jcm9113778
Ozga M, Zhao Q, Benson D, Elder P, Williams N, Bumma N, Rosko A, Chaudhry M, Khan A, Devarakonda S, et al. AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes. Journal of Clinical Medicine. 2020; 9(11):3778. https://doi.org/10.3390/jcm9113778
Chicago/Turabian StyleOzga, Michael, Qiuhong Zhao, Don Benson, Patrick Elder, Nita Williams, Naresh Bumma, Ashley Rosko, Maria Chaudhry, Abdullah Khan, Srinivas Devarakonda, and et al. 2020. "AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes" Journal of Clinical Medicine 9, no. 11: 3778. https://doi.org/10.3390/jcm9113778