New Light Chain Amyloid Response Criteria Help Risk Stratification of Patients by Day 100 after Autologous Hematopoietic Cell Transplantation

Biol Blood Marrow Transplant. 2016 Apr;22(4):768-770. doi: 10.1016/j.bbmt.2015.12.021. Epub 2015 Dec 29.

Abstract

Hematologic response criteria in light chain (AL) amyloidosis were updated in 2012 to incorporate free light chain responses. These criteria have been validated in autologous hematopoietic cell transplantation in AL at 6 and 12 months after transplantation. Using a transplantation registry, we assessed day 100 responses in AL amyloidosis. We validate the prognostic significance of the new criteria at this time point. Further, we show that patients who do not achieve at least a very good partial response by this time point have equally worse outcomes, regardless of depth of response (partial versus no response). Thus, we conclude that the new criteria help identify the poor responders by day 100 after transplantation and that this subset of patients should be studied for early evaluation in consolidation trials.

Keywords: 2012 response criteria; Day 100 post-transplantation response; Light chain (AL) amyloidosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Amyloidosis / blood
  • Amyloidosis / diagnosis
  • Amyloidosis / mortality
  • Amyloidosis / therapy*
  • Biomarkers / blood
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light-chain Amyloidosis
  • Male
  • Melphalan / therapeutic use*
  • Middle Aged
  • Myeloablative Agonists / therapeutic use*
  • Prognosis
  • Registries*
  • Risk Assessment
  • Survival Analysis
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Biomarkers
  • Immunoglobulin Light Chains
  • Myeloablative Agonists
  • Melphalan