Efficacy of bortezomib, cyclophosphamide and dexamethasone in treatment-naïve patients with high-risk cardiac AL amyloidosis (Mayo Clinic stage III)
| Autor: | Arnaud Jaccard, Raymond L. Comenzo, Parameswaran Hari, Philip N. Hawkins, Murielle Roussel, Pierre Morel, Margaret Macro, Jean-Luc Pellegrin, Estibaliz Lazaro, Dania Mohty, Patrick Mercie, Olivier Decaux, Julian Gillmore, David Lavergne, Frank Bridoux, Ashutosh D. Wechalekar, Christopher P. Venner |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Haematologica, Vol 99, Iss 9 (2014) |
| Druh dokumentu: | article |
| ISSN: | 0390-6078 1592-8721 |
| DOI: | 10.3324/haematol.2014.104109 |
| Popis: | Bortezomib is an active agent in AL amyloidosis and responses to this drug in combination with cyclophosphamide and dexamethasone are both rapid and deep. Here we present an international, multicenter series of 60 patients with Mayo Clinic stage III cardiac amyloidosis to assess the impact of this regimen in improving outcomes in this poor-risk group. The median follow-up for the entire cohort is 11.8 months. The overall response rate was 68%. In a landmark analysis, examining patients who survived more than 3 months, the overall response rate was 86%. A cardiac response was seen in 32% of patients. The estimated 1-year survival rate for the whole cohort was 57% and 24 patients (40%) died while on therapy. Although unable to save the poorest risk patients, the combination of bortezomib, cyclophosphamide and dexamethasone can achieve a high number of hematologic and cardiac responses, likely improving overall survival and justifying a prospective trial. |
| Databáze: | Directory of Open Access Journals |
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