Improvement of amyloid-related symptoms after autologous stem cell transplantation in a patient with hepatomegaly, macroglossia and purpura

Bone Marrow Transplant. 1999 Aug;24(4):433-5. doi: 10.1038/sj.bmt.1701925.

Abstract

AL amyloidosis was diagnosed in a 56-year-old woman with spontaneous purpura, macroglossia and hepatomegaly, a serum IgGk monoclonal gammopathy and a 25% plasma cell bone marrow infiltration. She was started on high-dose treatment consisting of four monthly cycles of VID chemotherapy, then underwent a stem cell collection after priming with cyclophosphamide + G-CSF. Myeloablative therapy was with melphalan and busulfan. Hematologic recovery was fast and uncomplicated. At follow-up 22 months from ASCT, the patient shows a complete remission of the clonal plasma cell disorder, normalization of liver size and alkaline phosphatase level and a significant improvement in the signs of vascular and soft tissue amyloid infiltration.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloidosis / complications*
  • Amyloidosis / therapy*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Busulfan / therapeutic use
  • Cyclophosphamide / administration & dosage
  • Dexamethasone / administration & dosage
  • Drug Therapy, Combination
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematopoietic Stem Cell Transplantation*
  • Hepatomegaly*
  • Humans
  • Idarubicin / administration & dosage
  • Macroglossia*
  • Melphalan / therapeutic use
  • Middle Aged
  • Purpura*
  • Transplantation, Autologous
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Granulocyte Colony-Stimulating Factor
  • Vincristine
  • Dexamethasone
  • Cyclophosphamide
  • Busulfan
  • Melphalan
  • Idarubicin