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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3520-3526. Prepublished online as a Blood First Edition Paper on August 12, 2004; DOI 10.1182/blood-2004-05-1924. This Article Full Text (PDF) All Versions of this Article: 2004-05-1924v1 104/12/3520    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dhodapkar, M. V Articles by Barlogie, B. Search for Related Content PubMed PubMed Citation Articles by Dhodapkar, M. V Articles by Barlogie, B. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 21, 2004 Accepted July 20, 2004 Clinical efficacy of high dose dexamethasone with maintenance dexamethasone/alpha interferon in patients with primary systemic amyloidosis: results of United States intergroup trial southwest oncology group (SWOG) S9628 Madfhav V Dhodapkar*, Mohamad A Hussein, Erik Rasmussen, Alan Solomon, Richard A Larson, John J Crowley, and Bart Barlogie Laboratory of Tumor Immunology and Immunotherapy, Rockefeller University and Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA Cleveland Clinic Foundation, Cleveland, OH, USA Southwest Oncology Group Statistical Center, Seattle, WA, USA University of Tennessee Cancer Institute, Knoxville, TN, USA University of Chicago and Cancer and Leukemia Group B, Chicago, IL, USA University of Arkansas for Medical Sciences, Little Rock, AR, USA * Corresponding author; email: dhodapm{at}mail.rockefeller.edu. Current therapy of primary systemic (AL) amyloidosis with oral melphalan and prednisone remains unsatisfactory, with a median survival of only 13 months. Between 1996 and 2003, 93 patients with biopsy proven AL amyloidosis were enrolled in a prospective US national cooperative group trial. Treatment schema consisted of induction therapy with pulse dexamethasone (DEX), followed by maintenance therapy with DEX and alpha interferon. Hematologic complete remissions were observed in 24% and improvement in AL related organ dysfunction occurred in 45% of patients evaluable for response. Median survival of the entire cohort is 31 months, with an estimated 2 year overall (OS) and event free survival (EFS) of 60% and 52% respectively. Presence of congestive heart failure and increased level of serum beta 2 microglobulin (> 3.5 mg/L) were dominant predictors of adverse outcome. Estimated 2 year OS in transplant eligible patients with this approach was 78%. These data demonstrate for the first time in the context of a US multicenter prospective clinical trial, that front line therapy with a DEX based regimen in AL amyloidosis can lead to durable reversal of AL related organ dysfunction, and prolonged survival. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Interfering with amyloidosis David C. Seldin Blood 2004 104: 3419-3420. [Full Text] [PDF] This article has been cited by other articles: E. Kastritis, A. Anagnostopoulos, M. Roussou, S. Toumanidis, C. Pamboukas, M. Migkou, A. Tassidou, I. Xilouri, S. Delibasi, E. Psimenou, et al. Treatment of light chain (AL) amyloidosis with the combination of bortezomib and dexamethasone Haematologica, October 1, 2007; 92(10): 1351 - 1358. [Abstract] [Full Text] [PDF] A. D. Wechalekar, H. J. B. Goodman, H. J. Lachmann, M. Offer, P. N. Hawkins, and J. D. Gillmore Safety and efficacy of risk-adapted cyclophosphamide, thalidomide, and dexamethasone in systemic AL amyloidosis Blood, January 15, 2007; 109(2): 457 - 464. [Abstract] [Full Text] [PDF] A. Dispenzieri, M. Q. Lacy, S. R. Zeldenrust, S. R. Hayman, S. K. Kumar, S. M. Geyer, J. A. Lust, J. B. Allred, T. E. Witzig, S. V. Rajkumar, et al. The activity of lenalidomide with or without dexamethasone in patients with primary systemic amyloidosis Blood, January 15, 2007; 109(2): 465 - 470. [Abstract] [Full Text] [PDF] V. Sanchorawala Light-Chain (AL) Amyloidosis: Diagnosis and Treatment Clin. J. Am. Soc. Nephrol., November 1, 2006; 1(6): 1331 - 1341. [Abstract] [Full Text] [PDF] G. Merlini and M. J. Stone Dangerous small B-cell clones Blood, October 15, 2006; 108(8): 2520 - 2530. [Abstract] [Full Text] [PDF] G. Palladini, F. Lavatelli, P. Russo, S. Perlini, V. Perfetti, T. Bosoni, L. Obici, A. R. Bradwell, G. M. D'Eril, R. Fogari, et al. Circulating amyloidogenic free light chains and serum N-terminal natriuretic peptide type B decrease simultaneously in association with improvement of survival in AL Blood, May 15, 2006; 107(10): 3854 - 3858. [Abstract] [Full Text] [PDF] S. O. Schonland, H. Lokhorst, A. Buzyn, V. Leblond, U. Hegenbart, G. Bandini, A. Campbell, E. Carreras, A. Ferrant, L. Grommisch, et al. Allogeneic and syngeneic hematopoietic cell transplantation in patients with amyloid light-chain amyloidosis: a report from the European Group for Blood and Marrow Transplantation Blood, March 15, 2006; 107(6): 2578 - 2584. [Abstract] [Full Text] [PDF] R. L. Comenzo Light chains ahoy: pirating Thal/Dex for AL too Blood, April 1, 2005; 105(7): 2625 - 2625. [Full Text] [PDF] G. Palladini, V. Perfetti, S. Perlini, L. Obici, F. Lavatelli, R. Caccialanza, R. Invernizzi, B. Comotti, and G. Merlini The combination of thalidomide and intermediate-dose dexamethasone is an effective but toxic treatment for patients with primary amyloidosis (AL) Blood, April 1, 2005; 105(7): 2949 - 2951. [Abstract] [Full Text] [PDF]

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