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Efficacy of the combination of bortezomib and dexamethasone in systemic AL amyloidosis

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Abstract

Bortezomib–dexamethasone (Btz/Dex) is an active regimen in patients with multiple myeloma and has been used in few patients with amyloidosis. Here, we report a retrospective evaluation of the efficacy and toxicity of Btz/Dex in 26 patients with AL amyloidosis (AL). Eighteen patients (69%) received Btz/Dex as first-line treatment. Organs most frequently involved were kidneys (100%) and heart (35%); five patients (19%) had less than two organs involved. The overall response rate was 54% (14 of 26 patients), with eight patients (31%) achieving a hematologic complete remission (CR). All patients who reached a CR received Btz/Dex as first-line therapy. Median time to response was 7.5 weeks. Improvement in organ function was noticed in three patients (12%). Median progression-free survival (PFS) and overall survival (OS) was 5.0 and 18.7 months, respectively; in CR patients, however, median PFS and OS have not yet been reached. Toxicities were manageable, with hematological side effects being most common. No grade 3/4 neuropathy was observed. Our results confirm the activity of bortezomib/dexamethasone in patients with AL amyloidosis and suggest that patients achieving a CR have a marked benefit for survival.

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Authors and Affiliations

  1. Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    W. Lamm, B. Schauer-Stalzer, C. C. Zielinski & J. Drach

  2. Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria

    W. Willenbacher

  3. Department of Medicine I, Wilhelminenspital Vienna, Vienna, Austria

    N. Zojer, E. Müldür & H. Ludwig

  4. Division of Oncology, Department of Internal Medicine, Landeskrankenhaus Feldkirch, Feldkirch, Austria

    A. Lang

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  1. W. Lamm
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  2. W. Willenbacher
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  3. A. Lang
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  4. N. Zojer
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  5. E. Müldür
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  6. H. Ludwig
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  7. B. Schauer-Stalzer
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  8. C. C. Zielinski
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  9. J. Drach
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Correspondence to J. Drach.

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Lamm, W., Willenbacher, W., Lang, A. et al. Efficacy of the combination of bortezomib and dexamethasone in systemic AL amyloidosis. Ann Hematol 90, 201–206 (2011). https://doi.org/10.1007/s00277-010-1062-6

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  • DOI: https://doi.org/10.1007/s00277-010-1062-6

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