Microbiologically documented infections in patients undergoing high-dose melphalan and autologous stem cell transplantation for the treatment of light chain amyloidosis

Stem Cell Mobilization and Autologous Transplant for Immunoglobulin Light-Chain Amyloidosis

Stem cell transplantation was one of the first proven effective regimens for the management of immunoglobulin light-chain amyloidosis. Criteria for patient selection and the mobilization regimen become important features in ensuring a safe outcome. The technique of stem cell transplantation has evolved considerably in parallel with the development of new chemotherapeutic agents for the management of amyloidosis. Optimal outcomes require both the use of effective novel agent induction and appropriate application of high-dose chemotherapy with subsequent stem cell reconstitution.

Autologous stem cell transplantation in light-chain amyloidosis patients: a single-center experience in Korea

Autologous stem cell transplantation (ASCT) has improved the prognosis of selected patients with immunoglobulin amyloid light-chain (AL) amyloidosis. However, there exist little data regarding Asian patients receiving ASCT. We retrospectively analyzed 24 patients who were treated with ASCT for AL amyloidosis between 2007 and 2012. The median age at the time of ASCT was 56 years (range: 40-62 years), and in 63% of patients, the AL amyloidosis involved two or more organs. All patients except one received induction treatment such as cyclophosphamide, dexamethasone or thalidomide before ASCT, but only approximately half of these patients showed a hematologic response. After ASCT, the overall hematologic response was increased to 92% (22/24), which translated into increased organ response in 58% of patients (14/24). There was no transplantation-related mortality (0%) even though cardiac amyloidosis patients were included in our series. In conclusion, our results of ASCT in patients with AL amyloidosis were comparable to that of Western countries in terms of response and survival outcomes. Therefore, ASCT is an effective and feasible treatment approach for Asian patients with AL amyloidosis.