Abstract
Immune-modulatory drugs are active in immunoglobulin light-chain amyloidosis and the addition of alkylating agents can potentiate their action. In this phase II prospective trial we used cyclophosphamide, lenalidomide and dexamethasone in the treatment of 21 patients who were refractory (n=13, 62%) or relapsed (n=8, 38%) after prior treatment including melphalan in all cases, bortezomib in 4 and thalidomide in 6. Median number of cycles administered was 4 (range 2-9 cycles). Severe adverse events were observed in 57% of patients, most common being neutropenia (29%). The hematologic response rate was 62%, with one complete response and 5 very good partial responses. Overall median survival was three years. The achievement of CR/VGPR was associated with a significant survival advantage. The combination of cyclophosphamide, lenalidomide and dexamethasone is an effective treatment for relapsed/refractory AL amyloidosis, and good quality hematologic response should be the aim of treatment in this setting.
| Original language | English |
|---|---|
| Pages (from-to) | 433-436 |
| Number of pages | 4 |
| Journal | Haematologica |
| Volume | 98 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2013 |
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ASJC Scopus subject areas
- Hematology
- Medicine(all)
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A phase II trial of cyclophosphamide, lenalidomide and dexamethasone in previously treated patients with AL amyloidosis. / Palladini, Giovanni; Russo, Paola; Milani, Paolo; Foli, Andrea; Lavatelli, Francesca; Nuvolone, Mario; Perlini, Stefano; Merlini, Giampaolo.
In: Haematologica, Vol. 98, No. 3, 01.03.2013, p. 433-436.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A phase II trial of cyclophosphamide, lenalidomide and dexamethasone in previously treated patients with AL amyloidosis
AU - Palladini, Giovanni
AU - Russo, Paola
AU - Milani, Paolo
AU - Foli, Andrea
AU - Lavatelli, Francesca
AU - Nuvolone, Mario
AU - Perlini, Stefano
AU - Merlini, Giampaolo
PY - 2013/3/1
Y1 - 2013/3/1
N2 - Immune-modulatory drugs are active in immunoglobulin light-chain amyloidosis and the addition of alkylating agents can potentiate their action. In this phase II prospective trial we used cyclophosphamide, lenalidomide and dexamethasone in the treatment of 21 patients who were refractory (n=13, 62%) or relapsed (n=8, 38%) after prior treatment including melphalan in all cases, bortezomib in 4 and thalidomide in 6. Median number of cycles administered was 4 (range 2-9 cycles). Severe adverse events were observed in 57% of patients, most common being neutropenia (29%). The hematologic response rate was 62%, with one complete response and 5 very good partial responses. Overall median survival was three years. The achievement of CR/VGPR was associated with a significant survival advantage. The combination of cyclophosphamide, lenalidomide and dexamethasone is an effective treatment for relapsed/refractory AL amyloidosis, and good quality hematologic response should be the aim of treatment in this setting.
AB - Immune-modulatory drugs are active in immunoglobulin light-chain amyloidosis and the addition of alkylating agents can potentiate their action. In this phase II prospective trial we used cyclophosphamide, lenalidomide and dexamethasone in the treatment of 21 patients who were refractory (n=13, 62%) or relapsed (n=8, 38%) after prior treatment including melphalan in all cases, bortezomib in 4 and thalidomide in 6. Median number of cycles administered was 4 (range 2-9 cycles). Severe adverse events were observed in 57% of patients, most common being neutropenia (29%). The hematologic response rate was 62%, with one complete response and 5 very good partial responses. Overall median survival was three years. The achievement of CR/VGPR was associated with a significant survival advantage. The combination of cyclophosphamide, lenalidomide and dexamethasone is an effective treatment for relapsed/refractory AL amyloidosis, and good quality hematologic response should be the aim of treatment in this setting.
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U2 - 10.3324/haematol.2012.073593
DO - 10.3324/haematol.2012.073593
M3 - Article
C2 - 22983583
AN - SCOPUS:84874549558
VL - 98
SP - 433
EP - 436
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 3
ER -