Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis

Joseph R Mikhael, Steven R. Schuster, Victor H. Jimenez-Zepeda, Nancy Bello, Jacy Spong, Craig B. Reeder, Alexander Keith Stewart, Peter Leif Bergsagel, Rafael Fonseca

Research output: Contribution to journalArticle

206 Citations (Scopus)

Abstract

Cyclophosphamide, bortezomib, and dexamethasone (CyBorD) is highly effective in multiple myeloma. We treated patients with light chain amyloidosis (AL) before stem cell transplantation (ASCT), instead of ASCT in ineligible patients or as salvage. Treatment was a combination of bortezomib (1.5 mg/m 2weekly), cyclophosphamide (300 mg/m 2orally weekly), and dexamethasone (40 mg weekly). Seventeen patients received 2 to 6 cycles of CyBorD. Ten (58%) had symptomatic cardiac involvement, and 14 (82%) had 2 or more organs involved. Response occurred in 16 (94%), with 71% achieving complete hematologic response and 24% a partial response. Time to response was 2 months. Three patients originally not eligible for ASCT became eligible. CyBorD produces rapid and complete hematologic responses in the majority of patients with AL regardless of previous treatment or ASCT candidacy. It is well tolerated with few side effects. CyBorD warrants continued investigation as treatment for AL.

Original languageEnglish (US)
Pages (from-to)4391-4394
Number of pages4
JournalBlood
Volume119
Issue number19
DOIs
StatePublished - May 10 2012

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Amyloidosis
Cyclophosphamide
Dexamethasone
Stem Cell Transplantation
Stem cells
Salvaging
Multiple Myeloma
Therapeutics
Bortezomib
Light

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis. / Mikhael, Joseph R; Schuster, Steven R.; Jimenez-Zepeda, Victor H.; Bello, Nancy; Spong, Jacy; Reeder, Craig B.; Stewart, Alexander Keith; Bergsagel, Peter Leif; Fonseca, Rafael.

In: Blood, Vol. 119, No. 19, 10.05.2012, p. 4391-4394.

Research output: Contribution to journalArticle

Mikhael, Joseph R ; Schuster, Steven R. ; Jimenez-Zepeda, Victor H. ; Bello, Nancy ; Spong, Jacy ; Reeder, Craig B. ; Stewart, Alexander Keith ; Bergsagel, Peter Leif ; Fonseca, Rafael. / Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis. In: Blood. 2012 ; Vol. 119, No. 19. pp. 4391-4394.
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abstract = "Cyclophosphamide, bortezomib, and dexamethasone (CyBorD) is highly effective in multiple myeloma. We treated patients with light chain amyloidosis (AL) before stem cell transplantation (ASCT), instead of ASCT in ineligible patients or as salvage. Treatment was a combination of bortezomib (1.5 mg/m 2weekly), cyclophosphamide (300 mg/m 2orally weekly), and dexamethasone (40 mg weekly). Seventeen patients received 2 to 6 cycles of CyBorD. Ten (58{\%}) had symptomatic cardiac involvement, and 14 (82{\%}) had 2 or more organs involved. Response occurred in 16 (94{\%}), with 71{\%} achieving complete hematologic response and 24{\%} a partial response. Time to response was 2 months. Three patients originally not eligible for ASCT became eligible. CyBorD produces rapid and complete hematologic responses in the majority of patients with AL regardless of previous treatment or ASCT candidacy. It is well tolerated with few side effects. CyBorD warrants continued investigation as treatment for AL.",
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