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Early serum free light chain response after high-dose melphalan and stem cell transplantation predicts hematologic response in AL amyloidosis

Bone Marrow Transplantation volume 57, pages 306–308 (2022)Cite this article

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Immunoglobulin amyloid light chain (AL) amyloidosis is caused by a clonal plasma cell dyscrasia producing monoclonal light chains that misfold and form amyloid fibrils which can deposit in various tissues and organs. Deposition of amyloid fibrils can lead to progressive organ impairment, multi-organ failure, and death if left untreated. Therapy of AL amyloidosis has primarily been directed toward the plasma cell clone to decrease the production of amyloidogenic light chains. High-dose melphalan followed by autologous stem cell transplantation (HDM/SCT) is offered to highly selected patients with AL amyloidosis and leads to complete hematologic responses (CR) in 33–43%, organ responses in 40%, and median overall survival (OS) of 4–7.3 years [1, 2].

Criteria for hematologic and organ responses to treatment have been unified in 2005. These criteria were redefined in 2012 and validated even in patients undergoing HDM/SCT [3, 4].

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Authors and Affiliations

  1. Section of Hematology and Medical Oncology and Amyloidosis Center, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA

    Vanessa Fiorini Furtado, Dina Brauneis, J. Mark Sloan & Vaishali Sanchorawala

  2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Janice Weinberg & Noon Elhassan

Authors
  1. Vanessa Fiorini Furtado
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  2. Dina Brauneis
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  3. Janice Weinberg
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  4. Noon Elhassan
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  5. J. Mark Sloan
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  6. Vaishali Sanchorawala
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Contributions

VFF and VS developed the concept, collected data, analyzed data, and wrote all drafts of the manuscript; NE and JW performed statistical analysis; DB collected data and provided patient care; JMS edited the manuscript.

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Correspondence to Vaishali Sanchorawala.

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Furtado, V.F., Brauneis, D., Weinberg, J. et al. Early serum free light chain response after high-dose melphalan and stem cell transplantation predicts hematologic response in AL amyloidosis. Bone Marrow Transplant 57, 306–308 (2022). https://doi.org/10.1038/s41409-021-01535-z

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