Shimojima Y, Matsuda M, Ishii W, Koyama J, Yamamoto K, Shimodaira S, Sakashita K, Koike K, Ikeda SI. High-dose melphalan followed by autologous stem cell support in primary systemic AL amyloidosis with multiple organ involvement.
Intern Med 2005;
44:484-9. [PMID:
15942100 DOI:
10.2169/internalmedicine.44.484]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A patient with primary systemic AL amyloidosis achieved partial hematological response after 2 courses of VAD (vincristine, doxorubicin and dexamethasone) and subsequent high-dose melphalan followed by autologous peripheral blood stem cell transplantation despite involvement of multiple organs, including the heart. In this patient natriuretic peptides and free light chains in serum were useful as markers of cardiac involvement and therapeutic effects, respectively. When amyloidosis-related dysfunction is seen in multiple organs, this intensive chemotherapy might be a possible therapeutic option, although several modifications in the regimen and careful management are necessary.
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