Outcomes of bortezomib combination chemotherapies in autologous stem cell transplantation-ineligible patients with AL amyloidosis
- Author:
Joon Young HUR
1
;
Sang Eun YOON
;
Darae KIM
;
Jin-oh CHOI
;
Ju-Hong MIN
;
Byung Jun KIM
;
Jung Sun KIM
;
Jung Eun LEE
;
Joon Young CHOI
;
Eun-Seok JEON
;
Seok Jin KIM
;
Kihyun KIM
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:Blood Research 2021;56(4):266-278
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Treatment protocols for light chain (AL) amyloidosis have been derived from myeloma treatment. Bortezomib is a key drug used for the treatment of myeloma and AL amyloidosis. We retrospectively investigated the efficacy and toxicity of bortezomib-based chemotherapy in patients with newly diagnosed AL amyloidosis.
Methods:We reviewed the outcomes of newly diagnosed autologous stem cell transplantation (auto-SCT)-ineligible AL amyloidosis patients who received bortezomib-based chemotherapy at a referral center between 2011 and 2017.
Results:Of 63 patients who received bortezomib-based chemotherapy, 32 were male, and the median age was 66 years (range, 42‒82 yr). The hematologic overall response rate (ORR) was 65.1%, and the chemotherapy regimen with the best hematologic response was VMP (75.7%, 28/37). Sixty patients had significant organ (heart or kidney) involvement; 28.3% of patients (N=17) had major organ responses after chemotherapy. With a median follow-up of 34 months, there was no significant difference in progression-free survival (P =0.49) or overall survival (P =0.67) according to regimen. Most hematologic and non-hematologic problems were manageable.
Conclusion:Various chemotherapy combinations based on bortezomib are currently employed in the clinical setting, but no difference was found in terms of efficacy or toxicity.
