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Autologous hematopoietic stem cell transplantation in light chain amyloidosis (AL) with renal involvement

Bone Marrow Transplantation volume 51, pages 307–309 (2016)Cite this article

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Approximately 70% of patients with primary light chain amyloidosis (AL) present with kidney involvement. Achievement of renal response is associated with improved overall survival (OS). OS for patients with AL treated with conventional chemotherapy ranges from 13 to 18 months1 with many progressing to end-stage renal disease and a poor long-term outcome. High-dose (HD) melphalan followed by autologous hematopoietic stem cell transplantation (auto-HCT) has been shown to improve organ function and OS by inducing high rates of both hematologic and organ responses.2 Organ response rates range from 31 to 46% and are time dependent, with a median time to best response of up to 1 year.3

In a large 8-year longitudinal study of patients undergoing HD melphalan and auto-HCT, Skinner et al.4 demonstrated an improved median OS of 4.6 years. Historically, the treatment-related mortality (TRM) of this approach has been as high as 25–40% (ref. 5). However, with better patient selection and improvements in supportive care, TRM has now decreased to <10% (ref. 3).

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    A M Cornelison, R M Saliba, A Afrough, Y Dinh, Y Nieto, Q Bashir, N Shah, S Parmar, C Hosing, U Popat, E Shpall, R Champlin & M H Qazilbash

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  1. A M Cornelison
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  2. R M Saliba
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  3. A Afrough
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Correspondence to M H Qazilbash.

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Cornelison, A., Saliba, R., Afrough, A. et al. Autologous hematopoietic stem cell transplantation in light chain amyloidosis (AL) with renal involvement. Bone Marrow Transplant 51, 307–309 (2016). https://doi.org/10.1038/bmt.2015.242

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