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KMID : 1142020210560040266
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Blood Research
2021 Volume.56 No. 4 p.266 ~ p.278
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Outcomes of bortezomib combination chemotherapies in autologous stem cell transplantation-ineligible patients with AL amyloidosis
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Hur Joon-Young
Yoon Sang-Eun
Kim Da-Rae
Choi Jin-Oh
Min Ju-Hong
Kim Byung-Jun
Kim Jung-Sun
Lee Jung-Eun
Choi Joon-Young
Jeon Eun-Seok
Kim Seok-Jin
Kim Ki-Hyun
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Abstract
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Background: Treatment protocols for light chain (AL) amyloidosis have been derived from myeloma treatment. Bortezomib is a key drug used for the treatment of myeloma and AL amyloidosis. We retrospectively investigated the efficacy and toxicity of bortezomib- based chemotherapy in patients with newly diagnosed AL amyloidosis.
Methods: We reviewed the outcomes of newly diagnosed autologous stem cell transplantation (auto-SCT)-ineligible AL amyloidosis patients who received bortezomib-based chemotherapy at a referral center between 2011 and 2017.
Results: Of 63 patients who received bortezomib-based chemotherapy, 32 were male, and the median age was 66 years (range, 42?82 yr). The hematologic overall response rate (ORR) was 65.1%, and the chemotherapy regimen with the best hematologic response was VMP (75.7%, 28/37). Sixty patients had significant organ (heart or kidney) involvement; 28.3% of patients (N=17) had major organ responses after chemotherapy. With a median follow- up of 34 months, there was no significant difference in progression-free survival (P=0.49) or overall survival (P =0.67) according to regimen. Most hematologic and non-hematologic problems were manageable.
Conclusion: Various chemotherapy combinations based on bortezomib are currently employed in the clinical setting, but no difference was found in terms of efficacy or toxicity.
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KEYWORD
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Bortezomib, Light-chain amyloidosis, Transplant ineligible
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