eprintid: 10119873
rev_number: 25
eprint_status: archive
userid: 608
dir: disk0/10/11/98/73
datestamp: 2021-01-28 12:03:31
lastmod: 2022-04-08 09:59:25
status_changed: 2021-01-28 12:03:31
type: article
metadata_visibility: show
creators_name: Sharpley, FA
creators_name: Manwani, R
creators_name: Petrie, A
creators_name: Mahmood, S
creators_name: Sachchithanantham, S
creators_name: Lachmann, HJ
creators_name: Martinez De Azcona Naharro, A
creators_name: Gillmore, JD
creators_name: Whelan, CJ
creators_name: Fontana, M
creators_name: Cohen, O
creators_name: Hawkins, PN
creators_name: Wechalekar, AD
title: Autologous stem cell transplantation vs bortezomib based chemotheraphy for the first‐line treatment of systemic light chain amyloidosis in the UK
ispublished: pub
divisions: UCL
divisions: A01
divisions: B02
divisions: C10
divisions: D17
divisions: G90
divisions: D21
keywords: multiple myeloma, plasma cell neoplasms, transplantation
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: OBJECTIVES: The benefit of autologous stem cell transplantation (ASCT) in the treatment of light chain (AL) amyloidosis requires re-evaluation in the modern era. This retrospective case-matched study compares ASCT to bortezomib for the treatment of patients with AL amyloidosis. METHODS: Newly diagnosed patients with AL amyloidosis treated with ASCT or bortezomib between 2001-2018 were identified. Patients were excluded if the time from diagnosis to treatment exceeded 12 months. Patients were matched on a 1:1 basis, using a propensity matched scoring approach. RESULTS: A total of 136 propensity-score matched patients were included (ASCT n= 68, bortezomib n=68). There was no significant difference in overall survival at two years (p=0.908, HR: 0.95, CI:0.41-2.20). For ASCT vs. bortezomib: overall haematological response rate at six months was 90.6% vs. 92.5%; organ response at 12 months: cardiac (70.0% vs. 54%, p>0.999), renal (74% vs.24%, p=0.463)) liver (21% vs. 22%, p=0.048); median progression free survival (50 vs. 42 months p=0.058, HR:0.61, CI:0.37-1.02) and time to next treatment (68 vs. 45 months, p=0.145, HR:0.61, CI:0.31-1.19). More patients required treatment in the bortezomib group compared to ASCT group at 24 months (41 vs. 23, Chi squared p=0.004) and 48 months (57 vs 41, Chi squared p= 0.004). CONCLUSIONS: This small retrospective study suggests that there is no clear survival advantage of ASCT over bortezomib therapy. A prospective randomised controlled trial evaluating ASCT in AL amyloidosis is critically needed.
date: 2021-04
date_type: published
official_url: https://doi.org/10.1111/ejh.13582
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1843362
doi: 10.1111/ejh.13582
lyricists_name: Cohen, Oliver
lyricists_name: Fontana, Marianna
lyricists_name: Gillmore, Julian
lyricists_name: Hawkins, Philip
lyricists_name: Lachmann, Helen
lyricists_name: Manwani, Richa
lyricists_name: Petrie, Aviva
lyricists_name: Sharpley, Faye
lyricists_name: Wechalekar, Ashutosh
lyricists_id: OCOHE36
lyricists_id: MFONT56
lyricists_id: JGILL78
lyricists_id: PNHAW77
lyricists_id: HJLAC80
lyricists_id: RMANW28
lyricists_id: APETR26
lyricists_id: FSHAR53
lyricists_id: AWECH53
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: European Journal of Haematology
volume: 106
number: 4
pagerange: 537-545
event_location: England
citation:        Sharpley, FA;    Manwani, R;    Petrie, A;    Mahmood, S;    Sachchithanantham, S;    Lachmann, HJ;    Martinez De Azcona Naharro, A;                         ... Wechalekar, AD; + view all <#>        Sharpley, FA;  Manwani, R;  Petrie, A;  Mahmood, S;  Sachchithanantham, S;  Lachmann, HJ;  Martinez De Azcona Naharro, A;  Gillmore, JD;  Whelan, CJ;  Fontana, M;  Cohen, O;  Hawkins, PN;  Wechalekar, AD;   - view fewer <#>    (2021)    Autologous stem cell transplantation vs bortezomib based chemotheraphy for the first‐line treatment of systemic light chain amyloidosis in the UK.                   European Journal of Haematology , 106  (4)   pp. 537-545.    10.1111/ejh.13582 <https://doi.org/10.1111/ejh.13582>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10119873/1/ejh.13582.pdf