IgM AL amyloidosis due to B cell lymphoproliferative disorder: efficacy of high-dose melphalan followed by autologous stem cell transplantation

Amyloid. 2004 Jun;11(2):130-5. doi: 10.1080/13506120410001725994.

Abstract

This report concerns a patient with IgM AL amyloidosis due to a B cell lymphoproliferative disorder who was successfully treated with VAD and subsequent high-dose melphalan followed by autologous stem cell support. After this chemotherapeutic regimen, the patient showed complete hematological remission and improvement in nephrotic syndrome. These findings suggest that high-dose melphalan may also be effective for lymphoplasmacytoid cells producing monoclonal IgM which are phenotypically distinct from plasma cells. Myeloablative therapies, such as high-dose melphalan, should definitely be considered as a treatment option for AL amyloidosis, irrespective of the type of precursor immunoglobulin.

Publication types

  • Case Reports

MeSH terms

  • Amyloidosis / complications
  • Amyloidosis / therapy*
  • B-Lymphocytes / immunology
  • Humans
  • Immunoglobulin M / immunology*
  • Lymphoproliferative Disorders / complications
  • Lymphoproliferative Disorders / immunology
  • Lymphoproliferative Disorders / therapy*
  • Male
  • Melphalan / therapeutic use*
  • Middle Aged
  • Plasma Cells / immunology
  • Stem Cell Transplantation*
  • Transplantation, Autologous

Substances

  • Immunoglobulin M
  • Melphalan