Outcomes with early vs. deferred stem cell transplantation in light chain amyloidosis

Nadine Abdallah, Surbhi Sidana, Angela Dispenzieri, Martha Lacy, Francis Buadi, Suzanne Hayman, Prashant Kapoor, Nelson Leung, David Dingli, Yi Lisa Hwa, John Lust, Stephen Russell, Wilson Gonsalves, Ronald Go, William Hogan, Robert Kyle, S. Vincent Rajkumar, Morie Gertz, Shaji Kumar

Research output: Contribution to journalArticle

Abstract

In the presence of effective treatment options for systemic light chain (AL) amyloidosis, autologous stem cell transplantation (ASCT) is sometimes deferred after stem cell collection. We designed this retrospective study to compare overall survival (OS) between patients who proceed directly to ASCT after stem cell collection and those who defer ASCT. We included patients with AL amyloidosis who had stem cell collection at Mayo Clinic, Minnesota, from 2004 to 2018. ASCT was considered “early” if performed within 90 days of collection, and “deferred” if performed after 90 days, or not done by last follow up. We included 651 patients; 527 underwent early ASCT and 124 deferred ASCT. There was no difference in OS with early vs. deferred ASCT (median OS: 13.0 vs. 11.4 years, respectively, P = 0.28). There was no difference in OS between the 2 groups among patients with early or advanced Mayo Stage. Among patients who achieved ≥very good partial response at the time of collection, OS in the early and deferred groups was 14.2 and 13.4 years, respectively (P = 0.06). Survival outcomes are similar with early and deferred ASCT. Further studies are needed to identify patients who would benefit from each approach.

Original languageEnglish (US)
Pages (from-to)1297-1304
Number of pages8
JournalBone Marrow Transplantation
Volume55
Issue number7
DOIs
StatePublished - Jul 1 2020

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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