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Auto-SCT improves survival in systemic light chain amyloidosis: a retrospective analysis with 14-year follow-up.
Bone Marrow Transplant. 2014 Aug;49(8):1036-41. doi: 10.1038/bmt.2014.115
Parmar S, Kongtim P, Champlin R, Dinh Y, Elgharably Y, Wang M, Bashir Q, Shah JJ, Shah N, Popat U, Giralt SA, Orlowski RZ, Qazilbash MH
Abstract:
.....We present a comparative outcome analysis of Auto-SCT to conventional therapies (CTR) in AL patients treated over a 14-year period at our institution. Out of the 145 AL amyloidosis patients, Auto-SCT was performed in 80 patients with 1-year non-relapse mortality rate of 12.5%. Novel agents were used as part of induction therapy in 56% of transplant recipients vs 46% of CTR patients. Hematological and organ responses were seen in 74.6% and 39% in the Auto-SCT arm vs 53% and 12% in the CTR arm, respectively. The projected 5-year survival for Auto-SCT vs CTR was 63% vs 38%, respectively. Landmark analysis of patients alive at 1-year after diagnosis showed improved 5-year OS of 72% with Auto-SCT vs 65% in the CTR arm. In the multivariate analysis, age <60 years, induction therapy with novel agents, kidney only involvement and Auto-SCT were associated with improved survival. In conclusion, Auto-SCT is associated with long-term survival for patients with AL amyloidosis.
PMID: 24887378
Tags: AL amyloidosis, review, stem cell transplant