TY - JOUR
T1 - Outcomes with early vs. deferred stem cell transplantation in light chain amyloidosis
AU - Abdallah, Nadine
AU - Sidana, Surbhi
AU - Dispenzieri, Angela
AU - Lacy, Martha
AU - Buadi, Francis
AU - Hayman, Suzanne
AU - Kapoor, Prashant
AU - Leung, Nelson
AU - Dingli, David
AU - Hwa, Yi Lisa
AU - Lust, John
AU - Russell, Stephen
AU - Gonsalves, Wilson
AU - Go, Ronald
AU - Hogan, William
AU - Kyle, Robert
AU - Rajkumar, S. Vincent
AU - Gertz, Morie
AU - Kumar, Shaji
N1 - Funding Information:
Conflict of interest S.S. served as a consultant for Janssen. A.D. received research funding from Celgene, Millennium Pharmaceuticals, Pfizer, and Janssen, and received a travel grant from Pfizer. M.G. served as a consultant for Millennium Pharmaceuticals and received honoraria from Celgene, Millennium Pharmaceuticals, Onyx Pharmaceuticals, Novartis, GlaxoSmithKline, Prothena, Ionis Pharmaceuticals, and Amgen. M.L. received research funding from Celgene. N.L. serves on an advisory board for Takeda Pharmaceuticals. S.K. served as a consultant for Celgene, Millennium Pharmaceuticals, Onyx Pharmaceuticals, Janssen, and Bristol-Myers Squibb, and received research funding from Celgene, Millennium Pharmaceuticals, Novar-tis, Onyx Pharmaceuticals, AbbVie, Janssen, and Bristol-Myers Squibb. The remaining authors declare no competing interests.
Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - In the presence of effective treatment options for systemic light chain (AL) amyloidosis, autologous stem cell transplantation (ASCT) is sometimes deferred after stem cell collection. We designed this retrospective study to compare overall survival (OS) between patients who proceed directly to ASCT after stem cell collection and those who defer ASCT. We included patients with AL amyloidosis who had stem cell collection at Mayo Clinic, Minnesota, from 2004 to 2018. ASCT was considered “early” if performed within 90 days of collection, and “deferred” if performed after 90 days, or not done by last follow up. We included 651 patients; 527 underwent early ASCT and 124 deferred ASCT. There was no difference in OS with early vs. deferred ASCT (median OS: 13.0 vs. 11.4 years, respectively, P = 0.28). There was no difference in OS between the 2 groups among patients with early or advanced Mayo Stage. Among patients who achieved ≥very good partial response at the time of collection, OS in the early and deferred groups was 14.2 and 13.4 years, respectively (P = 0.06). Survival outcomes are similar with early and deferred ASCT. Further studies are needed to identify patients who would benefit from each approach.
AB - In the presence of effective treatment options for systemic light chain (AL) amyloidosis, autologous stem cell transplantation (ASCT) is sometimes deferred after stem cell collection. We designed this retrospective study to compare overall survival (OS) between patients who proceed directly to ASCT after stem cell collection and those who defer ASCT. We included patients with AL amyloidosis who had stem cell collection at Mayo Clinic, Minnesota, from 2004 to 2018. ASCT was considered “early” if performed within 90 days of collection, and “deferred” if performed after 90 days, or not done by last follow up. We included 651 patients; 527 underwent early ASCT and 124 deferred ASCT. There was no difference in OS with early vs. deferred ASCT (median OS: 13.0 vs. 11.4 years, respectively, P = 0.28). There was no difference in OS between the 2 groups among patients with early or advanced Mayo Stage. Among patients who achieved ≥very good partial response at the time of collection, OS in the early and deferred groups was 14.2 and 13.4 years, respectively (P = 0.06). Survival outcomes are similar with early and deferred ASCT. Further studies are needed to identify patients who would benefit from each approach.
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U2 - 10.1038/s41409-020-0964-8
DO - 10.1038/s41409-020-0964-8
M3 - Article
C2 - 32518290
AN - SCOPUS:85086147166
SN - 0268-3369
VL - 55
SP - 1297
EP - 1304
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -