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Blood, 15 November 2005, Vol. 106, No. 10, pp. 3353-3357. Prepublished online as a Blood First Edition Paper on July 21, 2005; DOI 10.1182/blood-2005-03-1206. This Article Full Text (PDF) All Versions of this Article: 2005-03-1206v1 106/10/3353    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 Leung, N. Articles by Gertz, M. A Search for Related Content PubMed PubMed Citation Articles by Leung, N. Articles by Gertz, M. A Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 24, 2005 Accepted July 15, 2005 Excessive fluid accumulation during stem cell mobilization: a novel prognostic factor of first year survival after stem cell transplantation in AL amyloidosis patients Nelson Leung*, Tessa R Leung, Stephen S Cha, Angela Dispenzieri, Martha Q Lacy, and Morie A Gertz Nephrology, Mayo Clinic Rochester, Rochester, Minnesota, USA Department of Nursing, Mayo Clinic Rochester, Rochester, Minnesota, USA Department of Biostatistics, Mayo Clinic Rochester, Rochester, Minnesota, USA Division of Hematology, Mayo Clinic Rochester, Rochester, MInnesota, USA * Corresponding author; email: leung.nelson{at}mayo.edu. High dose melphalan followed by stem cell transplantation (HDM-SCT) has become the treatment of choice for patients with immunoglobulin light chain (AL) amyloidosis. Unfortunately, treatment mortality can be excessive in certain subpopulations. We have noted that patients who gained > 2% body weight during mobilization had a poorer outcome following HDM-SCT. Excluding 2 patients for lack of weight record and denial of consent, 126 patients between 7/97 and 6/03 were retrospectively studied. Weight increased > 2.0% during mobilization in 51.6% of the patients. Patients who accumulated > 2.0% tended to have more proteinuria, a higher number of organ involvement, lower serum albumin, more diuretic usage and dosage adjustment during mobilization. First year mortality was significantly higher in those with >2% weight gain (33.9% versus 9.8%, p = 0.002). Multivariate analysis showed weight gain, glomerular filtration rate and septal thickness to be independent predictors of first year mortality. The increase in mortality was noted even after the excess weight was diuresed prior to conditioning. The impact on mortality dissipated after the first year. Weight gain during mobilization appears to be a new marker of adverse outcome following HDM-SCT. Better prognostication may improve the treatment mortality rate of these patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: R. L. Comenzo How I treat amyloidosis Blood, October 8, 2009; 114(15): 3147 - 3157. [Abstract] [Full Text] [PDF] S. Kumar, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, N. Leung, S. R. Zeldenrust, F. K. Buadi, R. A. Kyle, S. V. Rajkumar, and M. A. Gertz Serum Uric Acid: Novel Prognostic Factor in Primary Systemic Amyloidosis Mayo Clin. Proc., March 1, 2008; 83(3): 297 - 303. [Abstract] [Full Text] [PDF] M. A. Gertz Autologous Attack on Amyloidosis Mayo Clin. Proc., July 1, 2006; 81(7): 874 - 876. [Full Text] [PDF] S. V. Rajkumar, A. Dispenzieri, and R. A. Kyle Monoclonal Gammopathy of Undetermined Significance, Waldenstrom Macroglobulinemia, AL Amyloidosis, and Related Plasma Cell Disorders: Diagnosis and Treatment Mayo Clin. Proc., May 1, 2006; 81(5): 693 - 703. [Abstract] [Full Text] [PDF]

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