Systemic Light Chain Amyloidosis, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology

Authors:
Shaji K. KumarMayo Clinic Cancer Center

Search for other papers by Shaji K. Kumar in
Current site
Google Scholar
PubMed
Close
 MD
,
Natalie S. CallanderUniversity of Wisconsin Carbone Cancer Center

Search for other papers by Natalie S. Callander in
Current site
Google Scholar
PubMed
Close
 MD
,
Kehinde AdekolaRobert H. Lurie Comprehensive Cancer Center of Northwestern University

Search for other papers by Kehinde Adekola in
Current site
Google Scholar
PubMed
Close
 MD, MSCI
,
Larry D. Anderson Jr.UT Southwestern Simmons Comprehensive Cancer Center

Search for other papers by Larry D. Anderson Jr. in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Muhamed BaljevicVanderbilt-Ingram Cancer Center

Search for other papers by Muhamed Baljevic in
Current site
Google Scholar
PubMed
Close
 MD
,
Erica CampagnaroUniversity of Michigan Rogel Cancer Center

Search for other papers by Erica Campagnaro in
Current site
Google Scholar
PubMed
Close
 MD
,
Jorge J. CastilloDana-Farber/Brigham and Women’s Cancer Center | Massachusetts General Hospital Cancer Center

Search for other papers by Jorge J. Castillo in
Current site
Google Scholar
PubMed
Close
 MD
,
Caitlin CostelloUC San Diego Moores Cancer Center

Search for other papers by Caitlin Costello in
Current site
Google Scholar
PubMed
Close
 MD
,
Christopher D’AngeloFred & Pamela Buffett Cancer Center

Search for other papers by Christopher D’Angelo in
Current site
Google Scholar
PubMed
Close
 MD
,
Srinivas DevarakondaThe Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute

Search for other papers by Srinivas Devarakonda in
Current site
Google Scholar
PubMed
Close
 MD
,
Noura ElsedawySt. Jude Children’s Research Hospital/The University of Tennessee Health Science Center

Search for other papers by Noura Elsedawy in
Current site
Google Scholar
PubMed
Close
 MD
,
Alfred GarfallAbramson Cancer Center at the University of Pennsylvania

Search for other papers by Alfred Garfall in
Current site
Google Scholar
PubMed
Close
 MD
,
Kelly GodbyO’Neal Comprehensive Cancer Center at UAB

Search for other papers by Kelly Godby in
Current site
Google Scholar
PubMed
Close
 MD
,
Jens HillengassRoswell Park Comprehensive Cancer Center

Search for other papers by Jens Hillengass in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Leona HolmbergFred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance

Search for other papers by Leona Holmberg in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Myo HtutCity of Hope National Medical Center

Search for other papers by Myo Htut in
Current site
Google Scholar
PubMed
Close
 MD
,
Carol Ann HuffThe Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Search for other papers by Carol Ann Huff in
Current site
Google Scholar
PubMed
Close
 MD
,
Malin HultcrantzMemorial Sloan Kettering Cancer Center

Search for other papers by Malin Hultcrantz in
Current site
Google Scholar
PubMed
Close
 MD, PhD
,
Yubin KangDuke Cancer Institute

Search for other papers by Yubin Kang in
Current site
Google Scholar
PubMed
Close
 MD
,
Sarah LarsonUCLA Jonsson Comprehensive Cancer Center

Search for other papers by Sarah Larson in
Current site
Google Scholar
PubMed
Close
 MD
,
Hans C. LeeThe University of Texas MD Anderson Cancer Center

Search for other papers by Hans C. Lee in
Current site
Google Scholar
PubMed
Close
 MD
,
Michaela LiedtkeStanford Cancer Institute

Search for other papers by Michaela Liedtke in
Current site
Google Scholar
PubMed
Close
 MD
,
Thomas MartinUCSF Helen Diller Family Comprehensive Cancer Center

Search for other papers by Thomas Martin in
Current site
Google Scholar
PubMed
Close
 MD
,
James OmelPatient advocate

Search for other papers by James Omel in
Current site
Google Scholar
PubMed
Close
 MD
,
Aaron RosenbergUC Davis Comprehensive Cancer Center

Search for other papers by Aaron Rosenberg in
Current site
Google Scholar
PubMed
Close
 MD
,
Douglas SborovHuntsman Cancer Institute at the University of Utah

Search for other papers by Douglas Sborov in
Current site
Google Scholar
PubMed
Close
 MD, MSc
,
Jason ValentCase Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute

Search for other papers by Jason Valent in
Current site
Google Scholar
PubMed
Close
 MD
,
Ryan BerardiNational Comprehensive Cancer Network

Search for other papers by Ryan Berardi in
Current site
Google Scholar
PubMed
Close
 MSc
, and
Rashmi KumarNational Comprehensive Cancer Network

Search for other papers by Rashmi Kumar in
Current site
Google Scholar
PubMed
Close
 PhD

Primary systemic light chain amyloidosis (SLCA) is characterized by production of light chains that get converted to amyloid fibrils with an affinity for visceral organs and causing organ dysfunction. The therapy for SLCA is directed to recovering the function of the affected organs by targeting the abnormal plasma cell clone and slowing deposition of amyloid fibrils. The NCCN Guidelines for SLCA provide recommendations for workup, diagnosis, and treatment of primary as well as previously treated SLCA.

Individual Disclosures for the NCCN Guidelines Panel for Systemic Light Chain Amyloidosis
Individual Disclosures for the NCCN Guidelines Panel for Systemic Light Chain Amyloidosis

  • Collapse
  • Expand
  • 1.

    Falk RH, Comenzo RL, Skinner M. The systemic amyloidoses. N Engl J Med 1997;337:898909.

  • 2.

    Quock TP, Yan T, Chang E, et al. Epidemiology of AL amyloidosis: a real-world study using US claims data. Blood Adv 2018;2:10461053.

  • 3.

    Dispenzieri A, Kyle R, Merlini G, et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia 2009;23:215224.

    • Search Google Scholar
    • Export Citation
  • 4.

    van Gameren II, Hazenberg BP, Bijzet J, et al. Diagnostic accuracy of subcutaneous abdominal fat tissue aspiration for detecting systemic amyloidosis and its utility in clinical practice. Arthritis Rheum 2006;54:20152021.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    van Gameren II, Hazenberg BP, Bijzet J, et al. Amyloid load in fat tissue reflects disease severity and predicts survival in amyloidosis. Arthritis Care Res (Hoboken) 2010;62:296301.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Swan N, Skinner M, O’Hara CJ. Bone marrow core biopsy specimens in AL (primary) amyloidosis. A morphologic and immunohistochemical study of 100 cases. Am J Clin Pathol 2003;120:610616.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Lachmann HJ, Wechalekar AD, Gillmore JD. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. N Engl J Med 2008;358:9192; author reply 92–93.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Lavatelli F, Perlman DH, Spencer B, et al. Amyloidogenic and associated proteins in systemic amyloidosis proteome of adipose tissue. Mol Cell Proteomics 2008;7:15701583.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Vrana JA, Gamez JD, Madden BJ, et al. Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood 2009;114:49574959.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Brambilla F, Lavatelli F, Di Silvestre D, et al. Reliable typing of systemic amyloidoses through proteomic analysis of subcutaneous adipose tissue. Blood 2012;119:18441847.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Gilbertson JA, Theis JD, Vrana JA, et al. A comparison of immunohistochemistry and mass spectrometry for determining the amyloid fibril protein from formalin-fixed biopsy tissue. J Clin Pathol 2015;68:314317.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Dispenzieri A, Gertz MA, Kyle RA, et al. Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. J Clin Oncol 2004;22:37513757.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Palladini G, Campana C, Klersy C, et al. Serum N-terminal pro-brain natriuretic peptide is a sensitive marker of myocardial dysfunction in AL amyloidosis. Circulation 2003;107:24402445.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Choufani EB, Sanchorawala V, Ernst T, et al. Acquired factor X deficiency in patients with amyloid light-chain amyloidosis: incidence, bleeding manifestations, and response to high-dose chemotherapy. Blood 2001;97:18851887.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Thompson CA, Kyle R, Gertz M, et al. Systemic AL amyloidosis with acquired factor X deficiency: a study of perioperative bleeding risk and treatment outcomes in 60 patients. Am J Hematol 2010;85:171173.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Comenzo RL, Zhou P, Fleisher M, et al. Seeking confidence in the diagnosis of systemic AL (Ig light-chain) amyloidosis: patients can have both monoclonal gammopathies and hereditary amyloid proteins. Blood 2006;107:34893491.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Lachmann HJ, Booth DR, Booth SE, et al. Misdiagnosis of hereditary amyloidosis as AL (primary) amyloidosis. N Engl J Med 2002;346:17861791.

  • 18.

    Maceira AM, Joshi J, Prasad SK, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation 2005;111:186193.

  • 19.

    Kumar S, Dispenzieri A, Lacy MQ, et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. J Clin Oncol 2012;30:989995.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Muchtar E, Kumar SK, Gertz MA, et al. Staging systems use for risk stratification of systemic amyloidosis in the era of high-sensitivity troponin T assay. Blood 2019;133:763766.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Gertz MA, Comenzo R, Falk RH, et al. Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, 18–22 April 2004. Am J Hematol 2005;79:319328.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Gertz MA, Merlini G. Definition of organ involvement and response to treatment in AL amyloidosis: an updated consensus opinion. Amyloid 2010;17:4849.

    • Search Google Scholar
    • Export Citation
  • 23.

    Palladini G, Dispenzieri A, Gertz MA, et al. New criteria for response to treatment in immunoglobulin light chain amyloidosis based on free light chain measurement and cardiac biomarkers: impact on survival outcomes. J Clin Oncol 2012;30:45414549.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Palladini G, Schönland SO, Sanchorawala V, et al. Clarification on the definition of complete haematologic response in light-chain (AL) amyloidosis. Amyloid 2021;28:12.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Sidiqi MH, Aljama MA, Muchtar E, et al. Autologous stem cell transplant for immunoglobulin light chain amyloidosis patients aged 70 to 75. Biol Blood Marrow Transplant 2018;24:21572159.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Al Saleh AS, Sidiqi MH, Muchtar E, et al. Outcomes of patients with light chain amyloidosis who had autologous stem cell transplantation with 3 or more organs involved. Biol Blood Marrow Transplant 2019;25:15201525.

    • Search Google Scholar
    • Export Citation
  • 27.

    Palladini G, Kastritis E, Maurer MS, et al. Daratumumab plus CyBorD for patients with newly diagnosed AL amyloidosis: safety run-in results of ANDROMEDA. Blood 2020;136:7180.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Kastritis E, Palladini G, Minnema MC, et al. Daratumumab-based treatment of immunoglobulin light-chain amyloidosis. N Engl J Med 2021;385:4658.

  • 29.

    Mikhael JR, Schuster SR, Jimenez-Zepeda VH, et al. Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis. Blood 2012;119:43914394.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Venner CP, Lane T, Foard D, et al. Cyclophosphamide, bortezomib, and dexamethasone therapy in AL amyloidosis is associated with high clonal response rates and prolonged progression-free survival. Blood 2012;119:43874390.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Shah GL, Kaul E, Fallo S, et al. Subcutaneous bortezomib in combination regimens in newly diagnosed patients with myeloma or systemic AL amyloidosis: high response rates and minimal toxicity. Blood 2012;120:Abstract 2968.

    • Search Google Scholar
    • Export Citation
  • 32.

    Palladini G, Sachchithanantham S, Milani P, et al. A European collaborative study of cyclophosphamide, bortezomib, and dexamethasone in upfront treatment of systemic AL amyloidosis. Blood 2015;126:612615.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Kastritis E, Wechalekar AD, Dimopoulos MA, et al. Bortezomib with or without dexamethasone in primary systemic (light chain) amyloidosis. J Clin Oncol 2010;28:10311037.

    • Search Google Scholar
    • Export Citation
  • 34.

    Wechalekar AD, Lachmann HJ, Offer M, et al. Efficacy of bortezomib in systemic AL amyloidosis with relapsed/refractory clonal disease. Haematologica 2008;93:295298.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Lamm W, Willenbacher W, Lang A, et al. Efficacy of the combination of bortezomib and dexamethasone in systemic AL amyloidosis. Ann Hematol 2011;90:201206.

  • 36.

    Singh V, Saad A, Palmer J, et al. Response to bortezomib based induction therapy in newly diagnosed light chain (AL) amyloidosis. Blood 2009;114:Abstract 1867.

    • Search Google Scholar
    • Export Citation
  • 37.

    Reece DE, Hegenbart U, Sanchorawala V, et al. Efficacy and safety of once-weekly and twice-weekly bortezomib in patients with relapsed systemic AL amyloidosis: results of a phase 1/2 study. Blood 2011;118:865873.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Reece DE, Hegenbart U, Sanchorawala V, et al. Long-term follow-up from a phase 1/2 study of single-agent bortezomib in relapsed systemic AL amyloidosis. Blood 2014;124:24982506.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Landau H, Hassoun H, Rosenzweig MA, et al. Bortezomib and dexamethasone consolidation following risk-adapted melphalan and stem cell transplantation for patients with newly diagnosed light-chain amyloidosis. Leukemia 2013;27:823828.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Gasparetto C, Sanchorawala V, Snyder RM, et al. Use of melphalan (M)/dexamethasone (D)/bortezomib in AL amyloidosis. J Clin Oncol 2010;28:Abstract 8024.

    • Search Google Scholar
    • Export Citation
  • 41.

    Zonder J, Sanchorawala V, Snyder R. Rapid haematologic and organ responses in patients with AL amyloid treated with bortezomib plus melphalan and dexamethasone. Amyloid 2010;17:86.

    • Search Google Scholar
    • Export Citation
  • 42.

    Kastritis E, Leleu X, Arnulf B, et al. Bortezomib, melphalan, and dexamethasone for light-chain amyloidosis. J Clin Oncol 2020;38:32523260.

  • 43.

    Kastritis E, Dialoupi I, Gavriatopoulou M, et al. Primary treatment of light-chain amyloidosis with bortezomib, lenalidomide, and dexamethasone. Blood Adv 2019;3:30023009.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Palladini G, Milani P, Foli A, et al. Oral melphalan and dexamethasone grants extended survival with minimal toxicity in AL amyloidosis: long-term results of a risk-adapted approach. Haematologica 2014;99:743750.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Kastritis E, Anagnostopoulos A, Roussou M, et al. Treatment of light chain (AL) amyloidosis with the combination of bortezomib and dexamethasone. Haematologica 2007;92:13511358.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Reece DE, Sanchorawala V, Hegenbart U, et al. Weekly and twice-weekly bortezomib in patients with systemic AL amyloidosis: results of a phase 1 dose-escalation study. Blood 2009;114:14891497.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Kaufman GP, Schrier SL, Lafayette RA, et al. Daratumumab yields rapid and deep hematologic responses in patients with heavily pretreated AL amyloidosis. Blood 2017;130:900902.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Schwotzer R, Manz MG, Pederiva S, et al. Daratumumab for relapsed or refractory AL amyloidosis with high plasma cell burden. Hematol Oncol 2019;37:595600.

    • Search Google Scholar
    • Export Citation
  • 49.

    Roussel M, Merlini G, Chevret S, et al. A prospective phase 2 trial of daratumumab in patients with previously treated systemic light-chain amyloidosis. Blood 2020;135:15311540.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Van de Wyngaert Z, Carpentier B, Pascal L, et al. Daratumumab is effective in the relapsed or refractory systemic light-chain amyloidosis but associated with high infection burden in a frail real-life population. Br J Haematol 2020;188:e2427.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Dispenzieri A, Kastritis E, Wechalekar AD, et al. Primary results from the phase 3 Tourmaline-AL1 trial of ixazomib-dexamethasone versus physician’s choice of therapy in patients (Pts) with relapsed/refractory primary systemic AL amyloidosis (RRAL). Blood 2019;134(Suppl_1):139.

    • Search Google Scholar
    • Export Citation
  • 52.

    Cohen OC, Sharpley F, Gillmore JD, et al. Use of ixazomib, lenalidomide and dexamethasone in patients with relapsed amyloid light-chain amyloidosis. Br J Haematol 2020;189:643649.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Kastritis E, Terpos E, Roussou M, et al. A phase 1/2 study of lenalidomide with low-dose oral cyclophosphamide and low-dose dexamethasone (RdC) in AL amyloidosis. Blood 2012;119:53845390.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Kumar SK, Hayman SR, Buadi FK, et al. Lenalidomide, cyclophosphamide, and dexamethasone (CRd) for light-chain amyloidosis: long-term results from a phase 2 trial. Blood 2012;119:48604867.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Palladini G, Russo P, Milani P, et al. A phase II trial of cyclophosphamide, lenalidomide and dexamethasone in previously treated patients with AL amyloidosis. Haematologica 2013;98:433436.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Dispenzieri A, Lacy MQ, Zeldenrust SR, et al. The activity of lenalidomide with or without dexamethasone in patients with primary systemic amyloidosis. Blood 2007;109:465470.

    • Search Google Scholar
    • Export Citation
  • 57.

    Sanchorawala V, Wright DG, Rosenzweig M, et al. Lenalidomide and dexamethasone in the treatment of AL amyloidosis: results of a phase 2 trial. Blood 2007;109:492496.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Mahmood S, Venner CP, Sachchithanantham S, et al. Lenalidomide and dexamethasone for systemic AL amyloidosis following prior treatment with thalidomide or bortezomib regimens. Br J Haematol 2014;166:842848.

    • Search Google Scholar
    • Export Citation
  • 59.

    Comenzo RL, Gertz MA. Autologous stem cell transplantation for primary systemic amyloidosis. Blood 2002;99:42764282.

  • 60.

    Gertz MA, Lacy MQ, Dispenzieri A, et al. Stem cell transplantation for the management of primary systemic amyloidosis. Am J Med 2002;113:549555.

  • 61.

    Goodman HJ, Gillmore JD, Lachmann HJ, et al. Outcome of autologous stem cell transplantation for AL amyloidosis in the UK. Br J Haematol 2006;134:417425.

  • 62.

    Jimenez-Zepeda VH, Franke N, Delgado D, et al. High-dose melphalan for AL amyloidosis: the importance of case selection to improve clinical outcomes. Blood 2010;116:Abstract 2403.

    • Search Google Scholar
    • Export Citation
  • 63.

    Wechalekar AD, Schonland SO, Kastritis E, et al. A European collaborative study of treatment outcomes in 346 patients with cardiac stage III AL amyloidosis. Blood 2013;121:34203427.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 64.

    Sanchorawala V. Role of high-dose melphalan and autologous peripheral blood stem cell transplantation in AL amyloidosis. Am J Blood Res 2012;2:917.

  • 65.

    Cordes S, Dispenzieri A, Lacy MQ, et al. Ten-year survival after autologous stem cell transplantation for immunoglobulin light chain amyloidosis. Cancer 2012;118:61056109.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 66.

    Dispenzieri A, Kyle RA, Lacy MQ, et al. Superior survival in primary systemic amyloidosis patients undergoing peripheral blood stem cell transplantation: a case-control study. Blood 2004;103:39603963.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 67.

    Gertz MA, Lacy MQ, Dispenzieri A, et al. Effect of hematologic response on outcome of patients undergoing transplantation for primary amyloidosis: importance of achieving a complete response. Haematologica 2007;92:14151418.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 68.

    Skinner M, Sanchorawala V, Seldin DC, et al. High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study. Ann Intern Med 2004;140:8593.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 69.

    Kumar SK, Dispenzieri A, Lacy MQ, et al. Changes in serum-free light chain rather than intact monoclonal immunoglobulin levels predicts outcome following therapy in primary amyloidosis. Am J Hematol 2011;86:251255.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 70.

    Gertz MA, Lacy MQ, Dispenzieri A, et al. Risk-adjusted manipulation of melphalan dose before stem cell transplantation in patients with amyloidosis is associated with a lower response rate. Bone Marrow Transplant 2004;34:10251031.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 71.

    Perfetti V, Siena S, Palladini G, et al. Long-term results of a risk-adapted approach to melphalan conditioning in autologous peripheral blood stem cell transplantation for primary (AL) amyloidosis. Haematologica 2006;91:16351643.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 72.

    Cibeira MT, Sanchorawala V, Seldin DC, et al. Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation: long-term results in a series of 421 patients. Blood 2011;118:43464352.

    • Search Google Scholar
    • Export Citation
  • 73.

    Gertz MA, Lacy MQ, Dispenzieri A, et al. Trends in day 100 and 2-year survival after auto-SCT for AL amyloidosis: outcomes before and after 2006. Bone Marrow Transplant 2011;46:970975.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 74.

    Sanchorawala V, Sun F, Quillen K, et al. Long-term outcome of patients with AL amyloidosis treated with high-dose melphalan and stem cell transplantation: 20-year experience. Blood 2015;126:23452347.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 75.

    Tsai SB, Seldin DC, Quillen K, et al. High-dose melphalan and stem cell transplantation for patients with AL amyloidosis: trends in treatment-related mortality over the past 17 years at a single referral center. Blood 2012;120:44454446.

    • Search Google Scholar
    • Export Citation
  • 76.

    Palladini G, Perfetti V, Obici L, et al. Association of melphalan and high-dose dexamethasone is effective and well tolerated in patients with AL (primary) amyloidosis who are ineligible for stem cell transplantation. Blood 2004;103:29362938.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 77.

    Palladini G, Russo P, Nuvolone M, et al. Treatment with oral melphalan plus dexamethasone produces long-term remissions in AL amyloidosis. Blood 2007;110:787788.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 78.

    Jaccard A, Moreau P, Leblond V, et al. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. N Engl J Med 2007;357:10831093.

  • 79.

    Jaccard A, Leblond V, Royer B, et al. Autologous stem cell transplantation (ASCT) versus oral melphalan and high-dose dexamethasone in patients with AL (primary) amyloidosis: long term follow-up of the French multicentric randomized trial. Blood 2010;116:Abstract 1344.

    • Search Google Scholar
    • Export Citation
  • 80.

    Dispenzieri A, Buadi F, Laumann K, et al. Activity of pomalidomide in patients with immunoglobulin light-chain amyloidosis. Blood 2012;119:53975404.

  • 81.

    Lentzsch S, Lagos GG, Comenzo RL, et al. Bendamustine with dexamethasone in relapsed/refractory systemic light-chain amyloidosis: results of a phase II study. J Clin Oncol 2020;38:14551462.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 82.

    Cohen AD, Landau H, Scott EC, et al. Safety and efficacy of carfilzomib (CFZ) in previously-treated systemic light-chain (AL) amyloidosis. Blood 2016;128:645.

    • Search Google Scholar
    • Export Citation
  • 83.

    Premkumar VJ, Lentzsch S, Pan S, et al. Venetoclax induces deep hematologic remissions in t(11;14) relapsed/refractory AL amyloidosis. Blood Cancer J 2021;11:10.

    • Search Google Scholar
    • Export Citation
  • 84.

    Wechalekar AD, Whelan C. Encouraging impact of doxycycline on early mortality in cardiac light chain (AL) amyloidosis. Blood Cancer J 2017;7:e546.

  • 85.

    D’Souza A, Flynn K, Chhabra S, et al. Rationale and design of DUAL study: doxycycline to upgrade response in light chain (AL) amyloidosis (DUAL): a phase 2 pilot study of a two-pronged approach of prolonged doxycycline with plasma cell-directed therapy in the treatment of AL amyloidosis. Contemp Clin Trials Commun 2017;8:3338.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 86.

    Shen KN, Fu WJ, Wu Y, et al. Doxycycline combined with bortezomib- cyclophosphamide-dexamethasone chemotherapy for newly diagnosed cardiac light-chain amyloidosis: a multicenter randomized controlled trial. Circulation 2022;145:817.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 87.

    Wechalekar AD, Cibeira MT, Gibbs SD, et al. Guidelines for non- transplant chemotherapy for treatment of systemic AL amyloidosis: EHA-ISA working group. Amyloid. Published online July 15, 2022. doi:10.1080/13506129.2022.2093635

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 17141 13534 1316
PDF Downloads 12377 10397 1078
EPUB Downloads 0 0 0