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  • Title: High-dose melphalan and autologous hematopoietic stem cell transplantation in primary amyloidosis: single-center results.
    Author: Charlinski G, Ziarkiewicz M, Boguradzki P, Wiater E, Torosian T, Dwilewicz-Trojaczek J, Wiktor-Jedrzejczak W.
    Journal: Transplant Proc; 2014 Oct; 46(8):2877-81. PubMed ID: 25380940.
    Abstract:
    BACKGROUND: Systemic immunoglobulin light-chain amyloidosis (AL) is a plasma cell dyscrasia resulting in multisystem organ failure and death. Autologous hematopoietic stem-cell transplantation (ASCT) has been widely used to treat patients with AL. However, treatment-related mortality remains high and reported series are subject to selection bias. METHODS: To define the role of patient selection in stem cell transplantation, we evaluated 24 consecutive AL patients transplanted at our center. RESULTS: Complete hematologic response was achieved in all 20 patients surviving >100 days posttransplantation. The 1-year overall survival (OS) rate after ASCT was 78.5%. The 5- and 10-year progression-free and OS rates were 57% and 47%, respectively. Treatment-related deaths owing to cardiovascular problems occurred in 16% of cases. CONCLUSION: ASCT for AL amyloidosis can be safely performed in experienced transplantation centers, and increased risk is associated mainly with cardiovascular system involvement.
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