Outcomes and treatments of patients with immunoglobulin light chain amyloidosis who progress or relapse postautologous stem cell transplant

Rahma Warsame, Soo Mee Bang, Shaji K Kumar, Morie Gertz, Martha Lacy, Francis Buadi, David M Dingli, Suzanne R. Hayman, Prashant Kapoor, Robert A. Kyle, Nelson Leung, John A. Lust, Stephen J Russell, Thomas Elmer Witzig, Steven R. Zeldenrust, S Vincent Rajkumar, Angela Dispenzieri

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Immunoglobulin light chain (AL) Amyloidosis is a condition whereby misfolded proteins generated by plasma cells deposit in tissues causing organ dysfunction. Chemotherapy and autologous stem cell transplant when eligible are standard treatment options. Several studies report long-term outcomes of patients post-transplant. However, there is a paucity of literature describing outcomes of relapsed patients post-transplant. We performed a retrospective study to assess outcomes and therapies employed upon relapse after transplant. Between 1996 and 2009, 410 patients received transplant at the Mayo Clinic as first-line therapy. Of those patients, 42 (10%) died within 3 months of transplant, 64 (16%) died without documented relapse, 158 (38%) were alive without documented progression, and 146 (36%) had documented progression. Those 146 patients are the subject of our study, and their median time to hematologic relapse/progression was 23.6 months (95%CI 18.3, 26.3 months). Their median overall survival and 5-yrs overall survival from post-transplant relapse/progression was 51.7 months (95%CI 34.1-62.3) and 39%, respectively. The most common first regimen for treatment after relapse was lenalidomide or thalidomide. In conclusion, our study indicates that patients with AL amyloidosis fare well post-transplant relapse/progression. Additionally, it provides a yardstick to design clinical trials to determine best treatment options.

Original languageEnglish (US)
Pages (from-to)485-490
Number of pages6
JournalEuropean Journal of Haematology
Volume92
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Immunoglobulin Light Chains
Amyloidosis
Stem Cells
Transplants
Recurrence
Therapeutics
Thalidomide
Survival
Plasma Cells
Retrospective Studies
Clinical Trials
Drug Therapy

Keywords

  • Amyloidosis
  • Prognosis
  • Relapse
  • Transplant
  • Treatment

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Outcomes and treatments of patients with immunoglobulin light chain amyloidosis who progress or relapse postautologous stem cell transplant. / Warsame, Rahma; Bang, Soo Mee; Kumar, Shaji K; Gertz, Morie; Lacy, Martha; Buadi, Francis; Dingli, David M; Hayman, Suzanne R.; Kapoor, Prashant; Kyle, Robert A.; Leung, Nelson; Lust, John A.; Russell, Stephen J; Witzig, Thomas Elmer; Zeldenrust, Steven R.; Rajkumar, S Vincent; Dispenzieri, Angela.

In: European Journal of Haematology, Vol. 92, No. 6, 2014, p. 485-490.

Research output: Contribution to journalArticle

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