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The prognosis of patients with amyloid light chain (AL) amyloidosis has improved since the introduction of treatment with alkylating agents and bortezomib (JW Oncol Hematol May 31 2011). Autologous stem cell transplantation (ASCT) has further improved survival rates but has increased the risk for treatment-related mortality (TRM) from amyloid-associated organ dysfunction.
Investigators now report long-term outcomes in 421 patients (median age, 56; 17% ≥65) who were diagnosed and treated between 1994 and 2008 at a single referral center with intravenous melphalan (100–200 mg/m2) and ASCT. Multiple organs were involved in 43% of patients, most often the kidney (84%) and heart (45%). Median follow-up was 4 years (range, 0 to 15.6 years).
Results…