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Short and long-term outcome of treatment with high-dose melphalan and stem cell transplantation for multiple myeloma-associated AL amyloidosis

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Abstract

High-dose melphalan chemotherapy and autologous peripheral blood stem cell transplantation (HDM/SCT) has been shown to result in a durable hematologic response and prolonged overall survival in systemic amyloid light-chain (AL) amyloidosis as well as multiple myeloma. However, little is known about the myeloma associated with AL amyloidosis (MM/AL). In this retrospective study, we evaluated 87 patients with MM/AL from 1994 to 2007. Sixteen of these patients underwent HDM/SCT at Boston University Medical Center. Three patients (19%) died from treatment-related mortality. The overall median survival for all 87 patients was 22 months by Kaplan–Meier estimates. However, this was improved to 54.5 months for those who received HDM/SCT compared to 21 months for those who did not receive HDM/SCT. A hematologic complete response was achieved by 25% (4/16) of patients at 6 months after HDM/SCT. Hematologic relapses occurred in 60% of patients at a median of 1 year after HDM/SCT. In conclusion, HDM/SCT can prolong overall survival in patients with MM/AL who are eligible to receive it.

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Acknowledgments

This clinical research was supported by grants from the National Institutes of Health (P01 HL68705), the Gerry Foundation, and the Amyloid Research Fund at Boston University.

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Authors and Affiliations

  1. Stem Cell Transplantation Program of the Section of Hematology-Oncology, FGH 1007, 820 Harrison Avenue, Boston, MA, 02118, USA

    David C. Seldin, Kathleen T. Finn, Karen Quillen & Vaishali Sanchorawala

  2. Amyloid Treatment and Research Program, Boston University School of Medicine, Boston, MA, USA

    Saulius Girnius, David C. Seldin, Martha Skinner, Kathleen T. Finn, Gheorghe Doros & Vaishali Sanchorawala

  3. Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA

    Karen Quillen

  4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Gheorghe Doros

Authors
  1. Saulius Girnius
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  2. David C. Seldin
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  3. Martha Skinner
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  4. Kathleen T. Finn
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  5. Karen Quillen
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  6. Gheorghe Doros
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  7. Vaishali Sanchorawala
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Corresponding author

Correspondence to Vaishali Sanchorawala.

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Girnius, S., Seldin, D.C., Skinner, M. et al. Short and long-term outcome of treatment with high-dose melphalan and stem cell transplantation for multiple myeloma-associated AL amyloidosis. Ann Hematol 89, 579–584 (2010). https://doi.org/10.1007/s00277-009-0874-8

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  • DOI: https://doi.org/10.1007/s00277-009-0874-8

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