Autologous stem cell transplant for immunoglobulin light chain amyloidosis: a status report

Abstract

High-dose chemotherapy for the management of immunoglobulin light chain amyloidosis remains an effective and viable treatment technique for selected patients with this disorder. We reviewed the medical records of 434 patients uniformly treated with high-dose chemotherapy and autologous stem cell transplant at Mayo Clinic, Rochester, Minnesota, between 8 March 1996 and 13 April 2010. Outcomes, engraftment, and predictors of early mortality were reviewed. Median survival has not been reached for the patients with a complete response, is 107 months for those with a partial response, and is 32 months for patients with no response (p < 0.001). The only predictor of survival was cardiac stage (p  < 0.001). The hematologic response rate is predictive for organ response rates. Both hematologic and organ responses are associated with improved survival.

Keywords:

• Amyloidosis
• multiple myeloma
• nephrotic syndrome
• restrictive cardiomyopathy
• stem cell transplant

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.