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Blood, 1 December 2006, Vol. 108, No. 12, pp. 3945-3947.
Prepublished online as a Blood First Edition Paper on August 22, 2006; DOI 10.1182/blood-2006-06-029728.

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TRANSPLANTATION
Brief report

Successful treatment of AL amyloidosis with high-dose melphalan and autologous stem cell transplantation in patients over age 65

David C. Seldin, Jennifer J. Anderson, Martha Skinner, Karim Malek, Daniel G. Wright, Karen Quillen, Kathleen Finn, Betul Oran, and Vaishali Sanchorawala

From the Amyloid Treatment and Research Program and Stem Cell Transplant Program of the Department of Medicine, and the Department of Pathology, Boston University Schools of Medicine and Public Health, MA.

Recently, protocols using high-dose melphalan chemotherapy and autologous peripheral blood stem cell transplantation (HDM/SCT) have been developed for the treatment of patients with immunoglobulin light chain (AL) amyloidosis. Although peritransplantation mortality is greater than for other hematologic diseases, treatment leads to durable hematologic complete responses, improvements in organ function and quality of life, and extended survival in a substantial proportion of patients. To determine whether this treatment can be applied to older patients, we have analyzed HDM/SCT treatment outcomes for 65 patients (aged 65 years or older) with AL amyloidosis compared with outcomes for 280 younger patients. For patients over age 65 years who meet the same eligibility criteria as younger patients, toxicity, hematologic remission rate, and survival were not significantly different from those observed in younger patients, indicating that older patients should not be excluded a priori from consideration for HDM/SCT treatment.


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Related Article in Blood Online:

Refining therapy for AL amyloidosis
Giampaolo Merlini
Blood 2006 108: 3632-3633. [Full Text] [PDF]





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