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Autografting

Autologous transplantation for primary systemic AL amyloidosis is feasible outside a major amyloidosis referral centre: the Calgary BMT Program experience

Bone Marrow Transplantation volume 36, pages 591–596 (2005)Cite this article

Summary:

Recent reports from large amyloidosis referral centers suggest that primary systemic AL amyloidosis patients treated with high-dose melphalan (HDM) and autologous stem cell transplantation (ASCT) survive longer than historical controls treated with less intensive chemotherapy, despite high transplant-related mortality (TRM) rates of >10%. A retrospective review was conducted to determine if the outcome of ASCT for AL amyloidosis at our institution was similar to that reported at major amyloidosis referral centers. Over a 7 year period, we treated a total of 15 AL amyloidosis patients with ASCT, including four with poor prognosis cardiac or multisystem involvement. No TRM was observed. Overall, 10 patients (67%) achieved a complete hematological response and four patients (27%) achieved a complete organ response. The 4-year event-free and overall survival rates were 60% (95% CI 32–89%) and 75% (95% CI 50–100%), respectively. One patient, who presented with cardiac failure and multiorgan involvement with colonic bleeding currently remains in complete remission 62 months post-ASCT. In conclusion, ASCT for primary AL amyloidosis can safely be performed at experienced transplant centers that are not associated with major amyloidosis referral centers, and is feasible for patients who have multisystem involvement, particularly for motivated patients with good performance status.

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Authors and Affiliations

  1. Departments of Medicine and Oncology, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada

    L Q M Chow, N Bahlis, J Russell, A Chaudhry, D Morris, C Brown & D A Stewart

  2. Tom Baker Cancer Center, Calgary, Alberta, Canada

    L Q M Chow, N Bahlis, J Russell, A Chaudhry, D Morris, C Brown & D A Stewart

Authors
  1. L Q M Chow
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  2. N Bahlis
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  3. J Russell
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  4. A Chaudhry
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  5. D Morris
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  6. C Brown
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  7. D A Stewart
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Correspondence to D A Stewart.

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Chow, L., Bahlis, N., Russell, J. et al. Autologous transplantation for primary systemic AL amyloidosis is feasible outside a major amyloidosis referral centre: the Calgary BMT Program experience. Bone Marrow Transplant 36, 591–596 (2005). https://doi.org/10.1038/sj.bmt.1705112

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  • DOI: https://doi.org/10.1038/sj.bmt.1705112

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