Bortezomib-dexamethasone versus high-dose melphalan for Japanese patients with systemic light-chain (AL) amyloidosis: a retrospective single-center study
Bortezomib-dexamethasone versus high-dose melphalan for Japanese patients with systemic light-chain (AL) amyloidosis: a retrospective single-center study
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DOI：
10.1007/s12185-016-2128-6
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Ikeda, Shu-ichi
中科院分区：
文献类型：
--
作者：
Katoh, Nagaaki;Ueno, Akihiro;Ikeda, Shu-ichi
硼替佐米-地塞米松（BD）和大剂量美法仑（HDM）对系统性轻链（AL）淀粉样变性有效，但尚未进行详细比较。我们回顾性调查了2001年9月至2016年6月期间在我们中心接受BD或HDM治疗的患者。234例患者中，20例接受BD治疗，30例接受HDM治疗。除年龄、移植资格和既往其他化疗史外，两组之间的大多数背景参数无显著差异。BD组中位年龄较高（63.2 vs. 55.8，P = 0.001），符合移植条件的患者数量较低（60.0 vs. 96.7%，P = 0.002），既往接受过治疗的患者数量较高（35.0 vs. 0.0%，P < 0.001）。BD组显示出治疗相关死亡率较低的趋势（5.0 vs. 10.0%，P = 0.641），血液学缓解更大（部分缓解或更佳）（90.0 vs. 73.3%，P = 0.279），更高的完全缓解率（60 vs. 50%，P = 0.487），与HDM组相似的生存率（均未达到，P = 0.705）。总之，BD与HDM一样有效和安全。值得注意的是，与HDM相比，BD在临床背景较差的患者中实现了这一结果。
Bortezomib-dexamethasone (BD) and high-dose melphalan (HDM) are effective for systemic light-chain (AL) amyloidosis, but have not been compared in detail. We retrospectively investigated patients treated with BD or HDM at our center between September 2001 and June 2016. Among 234 patients, 20 were treated with BD and 30 received HDM. With the exception of age, transplant eligibility, and previous history of other chemotherapy, there were no significant differences in most background parameters between the two groups. Median age was higher (63.2 vs. 55.8, P = 0.001), number of transplant-eligible patients was lower (60.0 vs. 96.7%, P = 0.002), and number of previously treated patients was higher (35.0 vs. 0.0%, P < 0.001) in the BD group. The BD group showed trends toward lower treatment-related mortality (5.0 vs. 10.0%, P = 0.641), greater hematological response (partial response or better) (90.0 vs. 73.3%, P = 0.279), higher complete response (60 vs. 50%, P = 0.487), and similar survival with the HDM group (neither reached, P = 0.705). In conclusion, BD was as effective and safe as HDM. Notably, BD achieved this outcome among patients with poorer clinical backgrounds compared with HDM.