Bortezomib-Based Induction Is Associated with Superior Outcomes in Light Chain Amyloidosis Patients Treated with Autologous Hematopoietic Cell Transplantation Regardless of Plasma Cell Burden.
Publication/Presentation Date
3-1-2021
Abstract
The benefits of pre-transplant induction chemotherapy in light chain (AL) amyloidosis, a low burden plasma cell (PC) neoplasm associated with multiorgan dysfunction, is debatable, although with the availability of bortezomib, this approach is being increasingly pursued. We analyzed the outcomes of AL amyloidosis patients undergoing autologous hematopoietic cell transplant between 2014 and 2018 that were reported to the Center for International Blood and Marrow Transplant Research database. Of 440 patients, 294 received bortezomib-based induction, and 146 received no induction. Patients receiving induction had greater PC burden compared to no induction (PC 10% or more, 39% versus 11%; P < .01). At 2 years, the induction group compared to no induction had lower relapse/progression: 13% (9% to 18%) versus 23% (16% to 32%) (P = .02); better progression-free survival (PFS): 82% (77% to 87%) versus 69% (61% to 77%) (P < .01); and similar overall survival (OS): 92% (88% to 95%) versus 89% (84% to 94%) (P = .22), findings that were confirmed on multivariate analysis. A subset analysis limited to patients with
Volume
27
Issue
3
First Page
1
Last Page
264
ISSN
2666-6367
Published In/Presented At
Cornell, R. F., Fraser, R., Costa, L., Goodman, S., Estrada-Merly, N., Lee, C., Hildebrandt, G., Gergis, U., Farhadfar, N., Freytes, C. O., Kamble, R. T., Krem, M., Kyle, R. A., Lazarus, H. M., Marks, D. I., Meehan, K., Patel, S. S., Ramanathan, M., Olsson, R. F., Wagner, J. L., … D'Souza, A. (2021). Bortezomib-Based Induction Is Associated with Superior Outcomes in Light Chain Amyloidosis Patients Treated with Autologous Hematopoietic Cell Transplantation Regardless of Plasma Cell Burden. Transplantation and cellular therapy, 27(3), 264.e1–264.e7. https://doi.org/10.1016/j.jtct.2020.11.018
Disciplines
Medicine and Health Sciences
PubMedID
33781533
Department(s)
Department of Medicine, Lehigh Valley Topper Cancer Institute
Document Type
Article