Haematologica, Vol 92, Issue 10, 1415-1418 doi:10.3324/haematol.11413
Copyright © 2007 by Ferrata Storti Foundation

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Amyloidosis

Effect of hematologic response on outcome of patients undergoing transplantation for primary amyloidosis: importance of achieving a complete response

Morie A. Gertz, Martha Q. Lacy, Angela Dispenzieri, Suzanne R. Hayman, Shaji K. Kumar, Nelson Leung, Dennis A. Gastineau

From the Division of Hematology (MAG, MQL, AD, SRH, SKK, DAG) and the Division of Nephrology and Hypertension (NL), Mayo Clinic, Rochester, Minnesota, USA

Correspondence: Morie A. Gertz, MD, Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. E-mail: gertz.morie{at}mayo.edu

Our objective was to determine whether the goal of high-dose therapy should be a partial hematologic response or a complete response. We analyzed 282 consecutive stem cell transplant patients. A partial hematologic response was achieved in 108 patients (38%), and 93 (33%) achieved a complete hematologic response. Survival rates of patients with complete, partial, or no response were significantly different (p<0.001), even after eliminating bias from early death. The degree of response was affected by the intensity of chemotherapy conditioning, septal thickness, and cardiac biomarkers. Hematologic response translates to longer survival.

Key words: amyloidosis, chemotherapy, complete response, immunoglobulin free light chain, stem cell transplant, survival.

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