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The patient summary below is from the full report titled "High-Dose Melphalan and Autologous Stem-Cell Transplantation in Patients with AL Amyloidosis: An 8-Year Study." It is in the 20 January 2004 issue of Annals of Internal Medicine (volume 140, pages 85-93). The authors are M. Skinner, V. Sanchorawala, D.C. Seldin, L.M. Dember, R.H. Falk, J.L. Berk, J.J. Anderson, C. O'Hara, K.T. Finn, C.A. Libbey, J. Wiesman, K. Quillen, N. Swan, and D.G. Wright.
What did the researchers find?
Half of all patients who received treatment survived for more than 4.5 years. Of 137 patients with heart involvement, half were alive after 1.5 years. Of those without heart involvement, half were alive after 6.5 years. Forty percent of treated patients had no evidence of AL amyloidosis after treatment (complete remission). Of those who remained in complete remission 1 year after treatment, 8% had relapses within 2 years but none had relapses after 2 years. Half of the patients who were not eligible for the treatment died within 4 months.
What were the limitations of the study?
Patients were collected from 6 different studies conducted over 6 years. Each study had somewhat different methods and chose different types of patients. Patients who were excluded from treatment (the comparison group) were older and sicker than those in the treatment group.
What are the implications of the study?
Treatment with high-dose melphalan and stem-cell transplantation can improve survival, even in patients with heart involvement.
Refer to Improved Treatment of AL Amyloidosis for more information. The full text article is available as #16 on the Professional Information page along with alternative treatments documented in articles #14, Measurement of Serum Free Light Chains in AL Amyloidosis, and #15, Melphalan and Dexamethasone in AL Amyloidosis.
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