Trends in day 100 and 2-year survival after auto-SCT for AL amyloidosis: outcomes before and after 2006
The role of auto-SCT in the management of Ig light-chain (AL) amyloidosis remains undefined. In this study, we report 422 patients who received auto-SCT for AL amyloidosis to compare outcomes of patients treated before January 2006 with those treated from January 2006 to 1 December 2009. Day 100 all...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2011-07, Vol.46 (7), p.970-975 |
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| creator | Gertz, M A Lacy, M Q Dispenzieri, A Kumar, S K Buadi, F K Dingli, D Leung, N Hogan, W J Hayman, S R |
| description | The role of auto-SCT in the management of Ig light-chain (AL) amyloidosis remains undefined. In this study, we report 422 patients who received auto-SCT for AL amyloidosis to compare outcomes of patients treated before January 2006 with those treated from January 2006 to 1 December 2009. Day 100 all-cause mortality decreased over this time period from 12 to 7% (
P
=0.09). Survival at 2 years increased from 78 to 82%. The major determinants of early mortality (before day 100) were the presence of cardiac involvement by amyloid with increased levels of cardiac biomarkers, lower serum albumin, higher serum creatinine and a higher number of organs involved. On multivariate survival analysis, higher levels of serum troponin T and
N
-terminal pro-brain natriuretic peptide were the only predictors of early mortality after auto-SCT. Improved supportive care and refined patient selection have improved the safety margin of patients undergoing auto-SCT; short-term mortality showed a more than 40% decrease after 2005. |
| doi_str_mv | 10.1038/bmt.2010.234 |
| format | Article |
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P
=0.09). Survival at 2 years increased from 78 to 82%. The major determinants of early mortality (before day 100) were the presence of cardiac involvement by amyloid with increased levels of cardiac biomarkers, lower serum albumin, higher serum creatinine and a higher number of organs involved. On multivariate survival analysis, higher levels of serum troponin T and
N
-terminal pro-brain natriuretic peptide were the only predictors of early mortality after auto-SCT. Improved supportive care and refined patient selection have improved the safety margin of patients undergoing auto-SCT; short-term mortality showed a more than 40% decrease after 2005.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2010.234</identifier><identifier>PMID: 20935685</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/699/317 ; 692/700/565/545/576/1855 ; Aged ; Amyloidosis ; Amyloidosis - mortality ; Amyloidosis - surgery ; Analysis ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Biomarkers ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Brain natriuretic peptide ; Calcium-binding protein ; Cardiology. Vascular system ; Care and treatment ; Cell Biology ; Creatinine ; Female ; Heart ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Hematology ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic Stem Cell Transplantation - statistics & numerical data ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Immunoglobulins ; Internal Medicine ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Natriuretic peptides ; Organs ; original-article ; Patient outcomes ; Physiological aspects ; Public Health ; Retrospective Studies ; Safety margins ; Serum albumin ; Stem cell transplantation ; Stem Cells ; Survival ; Survival analysis ; Survival Rate ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Treatment Outcome ; Troponin ; Troponin T ; United States</subject><ispartof>Bone marrow transplantation (Basingstoke), 2011-07, Vol.46 (7), p.970-975</ispartof><rights>Macmillan Publishers Limited 2011</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Nature Publishing Group</rights><rights>Macmillan Publishers Limited 2011.</rights><rights>Copyright Nature Publishing Group Jul 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-a240100e7482592abe3673cffd38b509d65a38adf100463297b042e884b6c1ef3</citedby><cites>FETCH-LOGICAL-c543t-a240100e7482592abe3673cffd38b509d65a38adf100463297b042e884b6c1ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/bmt.2010.234$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/bmt.2010.234$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24579336$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20935685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gertz, M A</creatorcontrib><creatorcontrib>Lacy, M Q</creatorcontrib><creatorcontrib>Dispenzieri, A</creatorcontrib><creatorcontrib>Kumar, S K</creatorcontrib><creatorcontrib>Buadi, F K</creatorcontrib><creatorcontrib>Dingli, D</creatorcontrib><creatorcontrib>Leung, N</creatorcontrib><creatorcontrib>Hogan, W J</creatorcontrib><creatorcontrib>Hayman, S R</creatorcontrib><title>Trends in day 100 and 2-year survival after auto-SCT for AL amyloidosis: outcomes before and after 2006</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>The role of auto-SCT in the management of Ig light-chain (AL) amyloidosis remains undefined. In this study, we report 422 patients who received auto-SCT for AL amyloidosis to compare outcomes of patients treated before January 2006 with those treated from January 2006 to 1 December 2009. Day 100 all-cause mortality decreased over this time period from 12 to 7% (
P
=0.09). Survival at 2 years increased from 78 to 82%. The major determinants of early mortality (before day 100) were the presence of cardiac involvement by amyloid with increased levels of cardiac biomarkers, lower serum albumin, higher serum creatinine and a higher number of organs involved. On multivariate survival analysis, higher levels of serum troponin T and
N
-terminal pro-brain natriuretic peptide were the only predictors of early mortality after auto-SCT. Improved supportive care and refined patient selection have improved the safety margin of patients undergoing auto-SCT; short-term mortality showed a more than 40% decrease after 2005.</description><subject>692/308/409</subject><subject>692/699/317</subject><subject>692/700/565/545/576/1855</subject><subject>Aged</subject><subject>Amyloidosis</subject><subject>Amyloidosis - mortality</subject><subject>Amyloidosis - surgery</subject><subject>Analysis</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Brain natriuretic peptide</subject><subject>Calcium-binding protein</subject><subject>Cardiology. Vascular system</subject><subject>Care and treatment</subject><subject>Cell Biology</subject><subject>Creatinine</subject><subject>Female</subject><subject>Heart</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Hematopoietic Stem Cell Transplantation - statistics & numerical data</subject><subject>Humans</subject><subject>Immunoglobulin Light-chain Amyloidosis</subject><subject>Immunoglobulins</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Natriuretic peptides</subject><subject>Organs</subject><subject>original-article</subject><subject>Patient outcomes</subject><subject>Physiological aspects</subject><subject>Public Health</subject><subject>Retrospective Studies</subject><subject>Safety margins</subject><subject>Serum albumin</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Survival Rate</subject><subject>Transfusions. Complications. Transfusion reactions. 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Vascular system</topic><topic>Care and treatment</topic><topic>Cell Biology</topic><topic>Creatinine</topic><topic>Female</topic><topic>Heart</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - methods</topic><topic>Hematopoietic Stem Cell Transplantation - statistics & numerical data</topic><topic>Humans</topic><topic>Immunoglobulin Light-chain Amyloidosis</topic><topic>Immunoglobulins</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Natriuretic peptides</topic><topic>Organs</topic><topic>original-article</topic><topic>Patient outcomes</topic><topic>Physiological aspects</topic><topic>Public Health</topic><topic>Retrospective Studies</topic><topic>Safety margins</topic><topic>Serum albumin</topic><topic>Stem cell transplantation</topic><topic>Stem Cells</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Survival Rate</topic><topic>Transfusions. 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In this study, we report 422 patients who received auto-SCT for AL amyloidosis to compare outcomes of patients treated before January 2006 with those treated from January 2006 to 1 December 2009. Day 100 all-cause mortality decreased over this time period from 12 to 7% (
P
=0.09). Survival at 2 years increased from 78 to 82%. The major determinants of early mortality (before day 100) were the presence of cardiac involvement by amyloid with increased levels of cardiac biomarkers, lower serum albumin, higher serum creatinine and a higher number of organs involved. On multivariate survival analysis, higher levels of serum troponin T and
N
-terminal pro-brain natriuretic peptide were the only predictors of early mortality after auto-SCT. Improved supportive care and refined patient selection have improved the safety margin of patients undergoing auto-SCT; short-term mortality showed a more than 40% decrease after 2005.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>20935685</pmid><doi>10.1038/bmt.2010.234</doi><tpages>6</tpages></addata></record> |
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| ispartof | Bone marrow transplantation (Basingstoke), 2011-07, Vol.46 (7), p.970-975 |
| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals; Nature Journals Online; EZB-FREE-00999 freely available EZB journals |
| subjects | 692/308/409 692/699/317 692/700/565/545/576/1855 Aged Amyloidosis Amyloidosis - mortality Amyloidosis - surgery Analysis Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Biomarkers Bone marrow Bone marrow, stem cells transplantation. Graft versus host reaction Brain natriuretic peptide Calcium-binding protein Cardiology. Vascular system Care and treatment Cell Biology Creatinine Female Heart Heart failure, cardiogenic pulmonary edema, cardiac enlargement Hematology Hematopoietic Stem Cell Transplantation - methods Hematopoietic Stem Cell Transplantation - statistics & numerical data Humans Immunoglobulin Light-chain Amyloidosis Immunoglobulins Internal Medicine Kaplan-Meier Estimate Male Medical sciences Medicine Medicine & Public Health Middle Aged Mortality Natriuretic peptides Organs original-article Patient outcomes Physiological aspects Public Health Retrospective Studies Safety margins Serum albumin Stem cell transplantation Stem Cells Survival Survival analysis Survival Rate Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Treatment Outcome Troponin Troponin T United States |
| title | Trends in day 100 and 2-year survival after auto-SCT for AL amyloidosis: outcomes before and after 2006 |
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