Treatment of patients with advanced cardiac AL amyloidosis with oral melphalan, dexamethasone, and thalidomide

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Abstract

Patients with primary (AL) amyloidosis and heart failure have a very poor prognosis and cannot tolerate aggressive therapy, such as autologous stem cell transplantation and high-dose dexamethasone-based regimens. We prospectively treated 22 patients with advanced cardiac amyloidosis combining oral melphalan, thalidomide, and reduced intensity dexamethasone (MTD). Six patients died due to cardiac amyloidosis before completing cycle 3. Early death was associated with reduced ejection fraction. Eight patients achieved a hematological response and four achieved a durable improvement of cardiac dysfunction. Treatment with MTD is feasible in patients with advanced cardiac AL amyloidosis and effective in subjects with preserved systolic function.

Original languageEnglish
Pages (from-to)347-350
Number of pages4
JournalAnnals of Hematology
Volume88
Issue number4
DOIs
Publication statusPublished - 2009

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Melphalan
Thalidomide
Amyloidosis
Dexamethasone
Therapeutics
Stem Cell Transplantation
Heart Failure

Keywords

  • Amyloidosis
  • Dexamethasone
  • Melphalan
  • Response
  • Thalidomide

ASJC Scopus subject areas

  • Hematology

Cite this

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abstract = "Patients with primary (AL) amyloidosis and heart failure have a very poor prognosis and cannot tolerate aggressive therapy, such as autologous stem cell transplantation and high-dose dexamethasone-based regimens. We prospectively treated 22 patients with advanced cardiac amyloidosis combining oral melphalan, thalidomide, and reduced intensity dexamethasone (MTD). Six patients died due to cardiac amyloidosis before completing cycle 3. Early death was associated with reduced ejection fraction. Eight patients achieved a hematological response and four achieved a durable improvement of cardiac dysfunction. Treatment with MTD is feasible in patients with advanced cardiac AL amyloidosis and effective in subjects with preserved systolic function.",
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author = "Giovanni Palladini and Paola Russo and Francesca Lavatelli and Mario Nuvolone and Riccardo Albertini and Tiziana Bosoni and Vittorio Perfetti and Laura Obici and Stefano Perlini and Remigio Moratti and Giampaolo Merlini",
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T1 - Treatment of patients with advanced cardiac AL amyloidosis with oral melphalan, dexamethasone, and thalidomide

AU - Palladini, Giovanni

AU - Russo, Paola

AU - Lavatelli, Francesca

AU - Nuvolone, Mario

AU - Albertini, Riccardo

AU - Bosoni, Tiziana

AU - Perfetti, Vittorio

AU - Obici, Laura

AU - Perlini, Stefano

AU - Moratti, Remigio

AU - Merlini, Giampaolo

PY - 2009

Y1 - 2009

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KW - Dexamethasone

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KW - Response

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