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
(2016) In Bone Marrow Transplantation 51(12). p.1569-1572- 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... (More)
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.
(Less)
- author
- Rosengren, S. ; Mellqvist, U. H. ; Nahi, H. ; Forsberg, K. ; Lenhoff, S. LU ; Strömberg, O. ; Ahlberg, L. ; Linder, O. and Carlson, K.
- publishing date
- 2016-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Bone Marrow Transplantation
- volume
- 51
- issue
- 12
- pages
- 4 pages
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:27694943
- scopus:84989853560
- ISSN
- 0268-3369
- DOI
- 10.1038/bmt.2016.249
- language
- English
- LU publication?
- no
- id
- acb5f792-e674-4315-9cc6-78fbec130c7a
- date added to LUP
- 2016-12-28 14:24:49
- date last changed
- 2024-02-03 07:41:03
@article{acb5f792-e674-4315-9cc6-78fbec130c7a,
abstract = {{<p>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.</p>}},
author = {{Rosengren, S. and Mellqvist, U. H. and Nahi, H. and Forsberg, K. and Lenhoff, S. and Strömberg, O. and Ahlberg, L. and Linder, O. and Carlson, K.}},
issn = {{0268-3369}},
language = {{eng}},
month = {{12}},
number = {{12}},
pages = {{1569--1572}},
publisher = {{Nature Publishing Group}},
series = {{Bone Marrow Transplantation}},
title = {{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}},
url = {{http://dx.doi.org/10.1038/bmt.2016.249}},
doi = {{10.1038/bmt.2016.249}},
volume = {{51}},
year = {{2016}},
}