Clinical profile and treatment outcome of older (>75 years) patients with systemic AL amyloidosis
| Autor: | Christopher P. Venner, Julian D. Gillmore, Helen J. Lachmann, Shameem Mahmood, Philip N. Hawkins, Thirusha Lane, Lisa Rannigan, Sajitha Sachchithanantham, Mark Offer, Darren Foard, Ashutosh D. Wechalekar |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Melphalan
Male medicine.medical_specialty Article Disease-Free Survival Internal medicine medicine AL amyloidosis Humans Survival rate Aged Very Good Partial Response Aged 80 and over Performance status business.industry Amyloidosis Hematology medicine.disease Hematologic Response Surgery Survival Rate Regimen Female business medicine.drug |
| Popis: | Systemic AL amyloidosis, a disease with improving outcomes using novel therapies, is increasingly recognized in the elderly but treatment and outcomes have not been systematically studied in this group of patients in whom comorbidities and frailty may compound morbidity and mortality. We report the outcomes of 295 patients with systemic AL amyloidosis ≥75 years seen at the UK National Amyloidosis Centre from 2005–2012. The median age was 78.5 years. The median overall survival was 20 months. Two hundred and thirty-eight patients received chemotherapy and 57 elected for supportive care only (overall survival – 24 and 8.4 months, respectively). On intention-to-treat analysis, 44% achieved a hematologic response including a very good partial response or better in 23%. The median overall survival was 6.2 years in patients achieving very good partial response or better at the 6-month landmark analysis and 1.5 years in non-responders. Factors independently indicating a poor prognosis were: cardiac involvement, performance status ≥2; systolic blood pressure |
| Databáze: | OpenAIRE |
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