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Immunoglobin-light-chain–related (AL) amyloidosis, in which monoclonal immunoglobulin light chains are deposited in tissues as amyloid, is incurable with available therapies. Survival after diagnosis typically is short, due to organ dysfunction and failure. Results of previous studies have suggested that dose-intensive chemotherapy with melphalan (Alkeran) followed by autologous stem-cell transplantation (ASCT) lengthens survival, albeit with high transplant-related mortality.
In a prospective multicenter French clinical trial, researchers compared standard-dose oral melphalan plus pulsed dexamethasone with high-dose intravenous melphalan plus ASCT in patients with biopsy-proven AL amyloidosis. Patients with symptomatic concurrent multiple m…