Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation
Abstract We retrospectively reviewed 292 patients who received a second line of therapy post ASCT for their light chain amyloidosis. Most patients (40%) were treated with an alkylator + PI ± dex or PI ± dex followed by an alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex (26%), an alkylator ± ste...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2022-04-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-022-00655-z |
| _version_ | 1818273420044926976 |
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| author | Abdullah S. Al Saleh Mohammad S. Ebraheem M. Hasib Sidiqi Angela Dispenzieri Eli Muchtar Francis K. Buadi Rahma Warsame Martha Q. Lacy David Dingli Wilson I. Gonsalves Taxiarchis V. Kourelis William J. Hogan Suzanne R. Hayman Prashant Kapoor Shaji K. Kumar Morie A. Gertz |
| author_facet | Abdullah S. Al Saleh Mohammad S. Ebraheem M. Hasib Sidiqi Angela Dispenzieri Eli Muchtar Francis K. Buadi Rahma Warsame Martha Q. Lacy David Dingli Wilson I. Gonsalves Taxiarchis V. Kourelis William J. Hogan Suzanne R. Hayman Prashant Kapoor Shaji K. Kumar Morie A. Gertz |
| author_sort | Abdullah S. Al Saleh |
| collection | DOAJ |
| description | Abstract We retrospectively reviewed 292 patients who received a second line of therapy post ASCT for their light chain amyloidosis. Most patients (40%) were treated with an alkylator + PI ± dex or PI ± dex followed by an alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex (26%), an alkylator ± steroid or steroid monotherapy (19%), a 2nd-gen IMiD + PI ± dex (6%), an alkylator + thalidomide ± dex (5%), or daratumumab-based therapy (4%). The rate of CR or VGPR was 70% among the daratumumab-based group, 62% in the alkylator + PI ± dex or PI ± dex group, 55% in the alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex group, 47% in the 2nd-gen IMiD + PI ± dex group, 24% in the alkylator ± steroid or steroid monotherapy group, and 18% in the alkylator + thalidomide ± dex group. The median OS was NR for the 2nd-gen IMiD + PI ± dex group and the daratumumab group, 130.4 months in the alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex group, 100 months for the alkylator + PI ± dex or PI ± dex group, 36 months for the alkylator ± steroid or steroid monotherapy group, and 21 months for the alkylator + thalidomide ± dex group (P < 0.0001). The median OS was 100 months in patients who received melphalan 200 mg/m2 compared to 41 months in the 140 mg/m2 group (P < 0.0001). In conclusion, patients receiving novel therapy post ASCT and melphalan conditioning dosing at 200 mg/m2 at diagnosis had better outcomes. |
| first_indexed | 2024-12-12T21:57:40Z |
| format | Article |
| id | doaj.art-a35e84cd0928430f9323a1c18bf23c69 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-12-12T21:57:40Z |
| publishDate | 2022-04-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-a35e84cd0928430f9323a1c18bf23c692022-12-22T00:10:35ZengNature Publishing GroupBlood Cancer Journal2044-53852022-04-011241610.1038/s41408-022-00655-zTreatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantationAbdullah S. Al Saleh0Mohammad S. Ebraheem1M. Hasib Sidiqi2Angela Dispenzieri3Eli Muchtar4Francis K. Buadi5Rahma Warsame6Martha Q. Lacy7David Dingli8Wilson I. Gonsalves9Taxiarchis V. Kourelis10William J. Hogan11Suzanne R. Hayman12Prashant Kapoor13Shaji K. Kumar14Morie A. Gertz15Division of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicDivision of Hematology, Department of Internal Medicine, Mayo ClinicAbstract We retrospectively reviewed 292 patients who received a second line of therapy post ASCT for their light chain amyloidosis. Most patients (40%) were treated with an alkylator + PI ± dex or PI ± dex followed by an alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex (26%), an alkylator ± steroid or steroid monotherapy (19%), a 2nd-gen IMiD + PI ± dex (6%), an alkylator + thalidomide ± dex (5%), or daratumumab-based therapy (4%). The rate of CR or VGPR was 70% among the daratumumab-based group, 62% in the alkylator + PI ± dex or PI ± dex group, 55% in the alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex group, 47% in the 2nd-gen IMiD + PI ± dex group, 24% in the alkylator ± steroid or steroid monotherapy group, and 18% in the alkylator + thalidomide ± dex group. The median OS was NR for the 2nd-gen IMiD + PI ± dex group and the daratumumab group, 130.4 months in the alkylator + 2nd-gen IMiD ± dex or 2nd-gen IMiD ± dex group, 100 months for the alkylator + PI ± dex or PI ± dex group, 36 months for the alkylator ± steroid or steroid monotherapy group, and 21 months for the alkylator + thalidomide ± dex group (P < 0.0001). The median OS was 100 months in patients who received melphalan 200 mg/m2 compared to 41 months in the 140 mg/m2 group (P < 0.0001). In conclusion, patients receiving novel therapy post ASCT and melphalan conditioning dosing at 200 mg/m2 at diagnosis had better outcomes.https://doi.org/10.1038/s41408-022-00655-z |
| spellingShingle | Abdullah S. Al Saleh Mohammad S. Ebraheem M. Hasib Sidiqi Angela Dispenzieri Eli Muchtar Francis K. Buadi Rahma Warsame Martha Q. Lacy David Dingli Wilson I. Gonsalves Taxiarchis V. Kourelis William J. Hogan Suzanne R. Hayman Prashant Kapoor Shaji K. Kumar Morie A. Gertz Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation Blood Cancer Journal |
| title | Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| title_full | Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| title_fullStr | Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| title_full_unstemmed | Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| title_short | Treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| title_sort | treatment and outcomes of patients with light chain amyloidosis who received a second line of therapy post autologous stem cell transplantation |
| url | https://doi.org/10.1038/s41408-022-00655-z |
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