Idelalisib plus rituximab is effective in systemic AL amyloidosis secondary to chronic lymphocytic leukaemia

Hematol Oncol. 2018 Feb;36(1):366-369. doi: 10.1002/hon.2480. Epub 2017 Oct 3.

Abstract

Light chain amyloidosis is characterized by the progressive deposition of immunoglobulin light chains into the extracellular tissue, leading to organ dysfunction. Usually, it is associated with an underlying clonal plasma cell dyscrasia and rarely with chronic lymphocytic leukaemia. Herein, we described the first report of a patient with relapsed chronic lymphocytic leukaemia harbouring TP53 abnormalities who developed, histologically proven, systemic light chain amyloidosis who was treated with the PI3K inhibitor, idelalisib, and rituximab. Unfortunately, the patient had sudden death during sleep, likely caused by arrhythmia secondary to amyloid cardiomyopathy. Idelalisib was at least effective in reducing secretory free light chain, chronic lymphocytic leukaemia burden, and to improve the survival of patient.

Keywords: CIDP; Idelalisib; PI3K; amyloidosis; chronic inflammatory demyelinating polyradiculoneuropathy; chronic lymphocytic leukaemia.

Publication types

  • Letter

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Male
  • Middle Aged
  • Purines / administration & dosage
  • Purines / pharmacology
  • Purines / therapeutic use*
  • Quinazolinones / administration & dosage
  • Quinazolinones / pharmacology
  • Quinazolinones / therapeutic use*
  • Rituximab / therapeutic use*

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Immunological
  • Purines
  • Quinazolinones
  • Rituximab
  • idelalisib