Dealing With High-Risk AL Amyloidosis Patients: A Single Hematologic Center Experience
| Autor: | Sara Altinier, Franco Noventa, Tamara Berno, Alberto Cipriani, Marcello Riva, Marny Fedrigo, Fausto Adami |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Bortezomib
Prognosis Cancer Research medicine.medical_specialty medicine.medical_treatment Dexamethasone Internal medicine medicine AL amyloidosis Humans Immunoglobulin Light-chain Amyloidosis Complete response Retrospective Studies Very Good Partial Response Chemotherapy Hematology business.industry Amyloidosis medicine.disease Hematologic Response Treatment Outcome Oncology business medicine.drug |
| Zdroj: | Clinical Lymphoma Myeloma and Leukemia. 21:e970-e974 |
| ISSN: | 2152-2650 |
| DOI: | 10.1016/j.clml.2021.07.015 |
| Popis: | Micro-Abstract In this limited retrospective analysis, we report on 52 “high risk” AL amyloidosis patients treated with first line bortezomib based chemotherapy. Achieving a hematological complete response (CR+VGPR) at day 30 confirmed its prognostic value. Nevertheless, patients who reached a suboptimal response (PR) at day 30 have a reasonable chances of survival, and do not necessarily need a change in therapeutic strategy even in the face of permissive clinical conditions. On the other hand, an early identification of NR patients should prompt a shift in therapy trying to improve the well-known dismal prognosis of these patients. We have also shown that even “high-risk” AL amyloidosis patients can be managed safely and effectively in a hematology ward. Purpose To assess the feasibility and the results of Bortezomib-based treatment of “high-risk” AL-amyloidosis patients in a hematology ward. Methods We report on 52 high-risk amyloidosis patients treated with first-line bortezomib-based chemotherapy. Results At day 30 from the beginning of the therapy, 23 patients (44%) achieved a hematological response (complete response plus very good partial response); 14 patients (27%) achieved a partial response; 15 patients (29%) were non-responders. After a median follow-up of 28.5 months, the survival rates were 18/23 (78%) for responders; 9/14 (64%) for partial responders and 3/15 (20%) for non-responders with a median overall survival of 43, 24 and 11 months, respectively (log-rank test: p Conclusions These results show that high-risk AL-amyloidosis patients can be managed safely and effectively in a hematology ward. A partial hematologic response may herald a later better response, organ response, and can allow a subsequent second-line therapy and a good survival. |
| Databáze: | OpenAIRE |
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