期刊
HAEMATOLOGICA
卷 98, 期 3, 页码 433-436出版社
FERRATA STORTI FOUNDATION
DOI: 10.3324/haematol.2012.073593
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资金
- Ministry of Health (Ricerca Finalizzata Malattie Rare)
- Istituto Superiore di Sanita [526D/63]
- Ministry of Research and University [2007AESFX2_003]
- Associazione Italiana per la Ricerca sul Cancro Program Harnessing tumor cell / microenvironment cross talk to treat mature B cell tumors
- Collegio Ghislieri, Pavia, Italy
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 rnelphalan 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. (clinicaltrials.gov identifier: NCT00607581)
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