Bortezomib, melphalan, and prednisolone combination chemotherapy for newly diagnosed light chain (AL) amyloidosis. (December 2014)

• Record Type: Journal Article
• Authors: Lee, Ji Yun; Lim, Sung Hee; Kim, Seok Jin; Lee, Ga Yeon; Lee, Jung Eun; Choi, Jin-Oh; Kim, Jung-Sun; Kim, Hee-Jin; Lee, Soo-Youn; Min, Ju-Hong; Jeon, Eun-Seok; Kim, Kihyun
• Is Part Of: Amyloid. Volume 21:Number 4(2014:Dec.)
• Page Start: 261
• Page End: 266
• Publication Date: 2014-12
• Subjects: Amyloidosis -- Periodicals; 616.3995
• DOI: 10.3109/13506129.2014.960560
• Languages: English
• ISSNs: 1350-6129

Abstract

<abstract> <title>Abstract</title> <p>Bortezomib combination chemotherapy appears to be active in light chain (AL) amyloidosis with high rates of hematologic and organ response. We report a retrospective evaluation of the clinical outcome of treatment with bortezomib, melphalan, and prednisolone (VMP) as first-line chemotherapy in patients with AL amyloidosis who were ineligible for autologous stem cell transplant. Among the 19 patients included in this study, 90% had two or more involved organs and most of the patients had advanced stage AL amyloidosis (84% with 2004 Mayo Stage III and 92% with 2012 Mayo Stage III or IV). Sixteen (84%) patients had a hematologic response, including seven (37%) with complete response, with time to response of 1–3 months. Cardiac and renal responses were observed in 44% and 33% of patients, respectively. Estimated 2-year survival is 39%, and 5 patients (26%) died during therapy. The common grade 3–4 adverse events were thrombocytopenia, diarrhea and pneumonia. A once-weekly bortezomib is more feasible than twice-weekly regimen. Our results suggest that triplet regimen of VMP appears to be an effective regimen in advanced AL amyloidosis, but benefits in the patients with multi-organ dysfunction remain to be proven.</p> </abstract>