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
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Amyloidosis / complications*
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Amyloidosis / therapy*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Busulfan / therapeutic use
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Cyclophosphamide / administration & dosage
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Dexamethasone / administration & dosage
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Drug Therapy, Combination
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Female
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Granulocyte Colony-Stimulating Factor / therapeutic use
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Hematopoietic Stem Cell Transplantation*
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Hepatomegaly*
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Humans
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Idarubicin / administration & dosage
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Macroglossia*
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Melphalan / therapeutic use
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Middle Aged
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Purpura*
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Transplantation, Autologous
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Treatment Outcome
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Vincristine / administration & dosage
Substances
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Granulocyte Colony-Stimulating Factor
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Vincristine
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Dexamethasone
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Cyclophosphamide
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Busulfan
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Melphalan
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Idarubicin