[Prognostic factors in light chain amyloidosis]

Orv Hetil. 2015 Sep 27;156(39):1577-84. doi: 10.1556/650.2015.30241.
[Article in Hungarian]

Abstract

Introduction: Light chain amyloidosis is characterized by extracellular deposition of a fibrillar material derived from immunglobulin light chain fragments.

Aim: The aim of the authors was to assess survival depending on cardiac involvement, therapy, and presence of myeloma.

Method: The authors studied a retrospective cohort of 29 patients with light chain amyloidosis (13 kappa, 16 lambda) treated in their institution between 2005 and 2014.

Results: Twenty-one patients had primary amyloidosis, while 8 had coexisting multiple myeloma. One, two and three or more organs were involved in 4, 8, and 17 patients, respectively. Cardiac involvement (22 cases) inversely correlated with survival. Fifteen (52%) patients received chemotherapy only, while 14 (48%) underwent autologous stem cell transplantation with a median survival of 87 and 11.4 months, respectively. Two patients had heart transplantation and survived 70 and 30 months. Median overall survival was 75.8 months.

Conclusions: Cardiac transplantation followed by autologous stem cell transplantation is feasible in selected patients with light chain amyloidosis and heart failure.

Keywords: amyloidosis; autologous stem cell transplantation; autológ őssejtátültetés; bortezomib; könnyűlánc; light chain.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amyloidosis / complications*
  • Amyloidosis / immunology
  • Amyloidosis / mortality
  • Amyloidosis / physiopathology
  • Amyloidosis / therapy*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Fatal Outcome
  • Female
  • Follow-Up Studies
  • Heart Failure / etiology
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart Transplantation*
  • Humans
  • Immunoglobulin Light-chain Amyloidosis
  • Immunoglobulin kappa-Chains / metabolism
  • Immunoglobulin lambda-Chains / metabolism
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Myeloma / complications
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / mortality
  • Multiple Myeloma / therapy*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stem Cell Transplantation*
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Immunoglobulin kappa-Chains
  • Immunoglobulin lambda-Chains