Successful reduced intensity allogeneic stem cell transplantation for systemic AL amyloidosis

Am J Hematol. 2006 Apr;81(4):281-3. doi: 10.1002/ajh.20544.

Abstract

No established treatments for systemic AL amyloidosis have been determined, and only four reports have described allogeneic stem cell transplantation for this disease. We report the case of a patient with orthostatic hypotension, diarrhea, nephrotic syndrome, and cardiac amyloidosis due to systemic AL amyloidosis. Reduced intensity allogeneic stem cell transplantation (RIST) was performed using a conditioning regimen comprising fludarabine 125 mg/m2 and melphalan 90 mg/m2. Hematologically complete remission and symptomatic improvement were obtained without severe transplantation-related complications. RIST may thus offer a useful treatment strategy for systemic AL amyloidosis complicated by cardiac amyloidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amyloidosis / blood
  • Amyloidosis / pathology
  • Amyloidosis / therapy*
  • Diarrhea / blood
  • Diarrhea / pathology
  • Diarrhea / therapy
  • Drug Therapy, Combination
  • Heart Diseases / blood
  • Heart Diseases / pathology
  • Heart Diseases / therapy*
  • Humans
  • Hypotension / blood
  • Hypotension / pathology
  • Hypotension / therapy
  • Japan
  • Kidney Diseases / blood
  • Kidney Diseases / pathology
  • Kidney Diseases / therapy
  • Male
  • Melphalan / administration & dosage*
  • Myeloablative Agonists / administration & dosage*
  • Peripheral Blood Stem Cell Transplantation* / methods
  • Remission Induction
  • Transplantation Conditioning* / methods
  • Transplantation, Homologous
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives*

Substances

  • Myeloablative Agonists
  • Vidarabine
  • fludarabine
  • Melphalan