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AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes

Background: Autologous stem cell transplantation (ASCT) remains an effective treatment option for many patients with systemic light chain (AL) amyloidosis. While maintenance post ASCT in multiple myeloma is now standard, the decision to utilize maintenance in AL amyloidosis remains largely unexplore...

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Autores principales: Ozga, Michael, Zhao, Qiuhong, Benson, Don, Elder, Patrick, Williams, Nita, Bumma, Naresh, Rosko, Ashley, Chaudhry, Maria, Khan, Abdullah, Devarakonda, Srinivas, Kahwash, Rami, Vallakati, Ajay, Campbell, Courtney, Parikh, Samir V., Almaani, Salem, Prosek, Jason, Bittengle, Jordan, Pfund, Katherine, LoRusso, Samantha, Freimer, Miriam, Redder, Elyse, Efebera, Yvonne, Sharma, Nidhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700492/
https://www.ncbi.nlm.nih.gov/pubmed/33238501
http://dx.doi.org/10.3390/jcm9113778
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author Ozga, Michael
Zhao, Qiuhong
Benson, Don
Elder, Patrick
Williams, Nita
Bumma, Naresh
Rosko, Ashley
Chaudhry, Maria
Khan, Abdullah
Devarakonda, Srinivas
Kahwash, Rami
Vallakati, Ajay
Campbell, Courtney
Parikh, Samir V.
Almaani, Salem
Prosek, Jason
Bittengle, Jordan
Pfund, Katherine
LoRusso, Samantha
Freimer, Miriam
Redder, Elyse
Efebera, Yvonne
Sharma, Nidhi
author_facet Ozga, Michael
Zhao, Qiuhong
Benson, Don
Elder, Patrick
Williams, Nita
Bumma, Naresh
Rosko, Ashley
Chaudhry, Maria
Khan, Abdullah
Devarakonda, Srinivas
Kahwash, Rami
Vallakati, Ajay
Campbell, Courtney
Parikh, Samir V.
Almaani, Salem
Prosek, Jason
Bittengle, Jordan
Pfund, Katherine
LoRusso, Samantha
Freimer, Miriam
Redder, Elyse
Efebera, Yvonne
Sharma, Nidhi
author_sort Ozga, Michael
collection PubMed
description Background: Autologous stem cell transplantation (ASCT) remains an effective treatment option for many patients with systemic light chain (AL) amyloidosis. While maintenance post ASCT in multiple myeloma is now standard, the decision to utilize maintenance in AL amyloidosis remains largely unexplored. The present study aims to determine the prognostic significance of utilizing maintenance therapy following ASCT and assess the impact of fluorescent in situ hybridization (FISH) abnormalities, bone marrow plasma cell burden (BMPC), and degree of organ involvement on this decision. Methods and results: This is a retrospective analysis of fifty AL amyloidosis patients who underwent ASCT at The Ohio State University. Twenty-eight patients received maintenance and twenty-two did not. Kaplan–Meier survival analysis was used to compare the effect of maintenance therapy with no significant difference in PFS (p = 0.66) and OS (p = 0.32) between the two groups. There was no difference in survival based on maintenance when further categorized by FISH, PFS (p = 0.15), and OS (p = 0.65); BMPC ≥ 10%, PFS (p = 0.49), and OS (p = 0.32); or with 2 or more organs involved, PFS (p = 0.34) and OS (p = 0.80). Conclusion: Maintenance therapy post ASCT did not impact PFS or OS when categorized by FISH abnormalities, increasing BMPC, or ≥2 organs involved in AL amyloidosis patients.
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spelling pubmed-77004922020-11-30 AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes Ozga, Michael Zhao, Qiuhong Benson, Don Elder, Patrick Williams, Nita Bumma, Naresh Rosko, Ashley Chaudhry, Maria Khan, Abdullah Devarakonda, Srinivas Kahwash, Rami Vallakati, Ajay Campbell, Courtney Parikh, Samir V. Almaani, Salem Prosek, Jason Bittengle, Jordan Pfund, Katherine LoRusso, Samantha Freimer, Miriam Redder, Elyse Efebera, Yvonne Sharma, Nidhi J Clin Med Article Background: Autologous stem cell transplantation (ASCT) remains an effective treatment option for many patients with systemic light chain (AL) amyloidosis. While maintenance post ASCT in multiple myeloma is now standard, the decision to utilize maintenance in AL amyloidosis remains largely unexplored. The present study aims to determine the prognostic significance of utilizing maintenance therapy following ASCT and assess the impact of fluorescent in situ hybridization (FISH) abnormalities, bone marrow plasma cell burden (BMPC), and degree of organ involvement on this decision. Methods and results: This is a retrospective analysis of fifty AL amyloidosis patients who underwent ASCT at The Ohio State University. Twenty-eight patients received maintenance and twenty-two did not. Kaplan–Meier survival analysis was used to compare the effect of maintenance therapy with no significant difference in PFS (p = 0.66) and OS (p = 0.32) between the two groups. There was no difference in survival based on maintenance when further categorized by FISH, PFS (p = 0.15), and OS (p = 0.65); BMPC ≥ 10%, PFS (p = 0.49), and OS (p = 0.32); or with 2 or more organs involved, PFS (p = 0.34) and OS (p = 0.80). Conclusion: Maintenance therapy post ASCT did not impact PFS or OS when categorized by FISH abnormalities, increasing BMPC, or ≥2 organs involved in AL amyloidosis patients. MDPI 2020-11-23 /pmc/articles/PMC7700492/ /pubmed/33238501 http://dx.doi.org/10.3390/jcm9113778 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ozga, Michael
Zhao, Qiuhong
Benson, Don
Elder, Patrick
Williams, Nita
Bumma, Naresh
Rosko, Ashley
Chaudhry, Maria
Khan, Abdullah
Devarakonda, Srinivas
Kahwash, Rami
Vallakati, Ajay
Campbell, Courtney
Parikh, Samir V.
Almaani, Salem
Prosek, Jason
Bittengle, Jordan
Pfund, Katherine
LoRusso, Samantha
Freimer, Miriam
Redder, Elyse
Efebera, Yvonne
Sharma, Nidhi
AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title_full AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title_fullStr AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title_full_unstemmed AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title_short AL Amyloidosis: The Effect of Maintenance Therapy on Autologous Stem Cell Transplantation Outcomes
title_sort al amyloidosis: the effect of maintenance therapy on autologous stem cell transplantation outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700492/
https://www.ncbi.nlm.nih.gov/pubmed/33238501
http://dx.doi.org/10.3390/jcm9113778
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