A phase II trial of lenalidomide, dexamethasone and cyclophosphamide for newly diagnosed patients with systemic immunoglobulin light chain amyloidosis

Summary Immunomodulatory drugs have been shown to be of benefit in relapsed/refractory immunoglobulin light‐chain (AL) amyloidosis. We designed a prospective, multicentre phase II trial of lenalidomide, dexamethasone and cyclophosphamide for newly diagnosed patients with AL amyloidosis not eligible...

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Bibliographic Details
Published in:British journal of haematology 2015-09, Vol.170 (6), p.804-813
Main Authors: Cibeira, Maria T., Oriol, Albert, Lahuerta, Juan J., Mateos, Maria‐Victoria, Rubia, Javier, Hernández, Miguel T., Granell, Miquel, Fernández de Larrea, Carlos, San Miguel, Jesús F., Bladé, Joan
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
AL amyloidosis
Amyloidosis - diagnosis
Amyloidosis - drug therapy
Amyloidosis - metabolism
Amyloidosis - mortality
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
cyclophosphamide
Cyclophosphamide - administration & dosage
dexamethasone
Dexamethasone - administration & dosage
Disease Progression
Female
Humans
Immunoglobulin Light Chains - metabolism
lenalidomide
Male
Middle Aged
Survival Analysis
Thalidomide - administration & dosage
Thalidomide - analogs & derivatives
Treatment Outcome
untreated
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Summary:Summary Immunomodulatory drugs have been shown to be of benefit in relapsed/refractory immunoglobulin light‐chain (AL) amyloidosis. We designed a prospective, multicentre phase II trial of lenalidomide, dexamethasone and cyclophosphamide for newly diagnosed patients with AL amyloidosis not eligible for autologous stem‐cell transplantation. Twenty‐eight patients were included in the study. Cardiac involvement was present in 23 patients; 14 of them had cardiac stage III. The overall haematological response rate was 46%, including complete and very good partial responses in 25% and 18% of patients respectively. Haematological response was mainly associated with absence of cardiac stage III and lower tumour burden. Organ response was observed in 46% of patients. After a median follow‐up of 24 months, median progression‐free and overall survival have not been reached, both being significantly longer in responders (P 
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.13500