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Plasma Cell Disorders

Auto-SCT improves survival in systemic light chain amyloidosis: a retrospective analysis with 14-year follow-up

Bone Marrow Transplantation volume 49, pages 1036–1041 (2014)Cite this article

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Abstract

Optimal treatment approach continues to remain a challenge for systemic light chain amyloidosis (AL). So far, Auto-SCT is the only modality associated with long-term survival. However, failure to show survival benefit in randomized study raises questions regarding its efficacy. 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.

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Acknowledgements

We thank Joshua Howell, PharmD, Mubeen A Khan and Hilal Gunaydin, MD for data collection.

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    S Parmar, P Kongtim, R Champlin, Y Dinh, Y Elgharably, Q Bashir, N Shah, U Popat & M H Qazilbash

  2. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M Wang, J J Shah & R Z Orlowski

  3. Department of Stem Cell Transplantation, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    S A Giralt

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  1. S Parmar
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Correspondence to S Parmar.

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Parmar, S., Kongtim, P., Champlin, R. et al. Auto-SCT improves survival in systemic light chain amyloidosis: a retrospective analysis with 14-year follow-up. Bone Marrow Transplant 49, 1036–1041 (2014). https://doi.org/10.1038/bmt.2014.115

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