PMID- 18080505
OWN - NLM
STAT- MEDLINE
DCOM- 20080221
LR  - 20071217
IS  - 0485-1439 (Print)
IS  - 0485-1439 (Linking)
VI  - 48
IP  - 11
DP  - 2007 Nov
TI  - [Long-term survival after autologous peripheral blood stem cell transplantation 
      in a patient with primary AL amyloidosis complicating congestive heart failure].
PG  - 1478-83
AB  - A 44-year-old man was admitted to hospital because of respiratory distress and 
      progressive edema in the lower extremities. He was diagnosed as having congestive 
      heart failure, but his condition improved following intensive care. 
      Echocardiogram revealed a thickened interventricular septum, insufficient 
      diastolic function, and granular sparkling pattern in the ventricular wall. 
      Pathological examination of a myocardial biopsy specimen showed the deposition of 
      AL amyloid, resulting in a diagnosis of AL amyloidosis. He was then referred to 
      our hospital for treatment. After a course of high-dose dexamethasone therapy, 
      peripheral blood stem cells induced by the administration of granulocyte colony 
      stimulating factor were harvested. He then received high-dose melphalan (HDM) 
      with autologous peripheral blood stem cell transplantation (auto-PBSCT) support, 
      leading to complete remission. He has been well for more than three years after 
      the transplantation and enjoys the same daily life as before the onset of 
      symptoms. HDM/auto-PBSCT for AL amyloidosis confers a higher response rate and 
      longer survival than conventional chemotherapies; however, treatment-related 
      toxicity is also high. Refinements of treatment strategies are urgently needed. 
      This case provides insights into appropriate strategies for HDM/auto-PBSCT for AL 
      amyloidosis with regard to patient selection, the best induction therapy, and the 
      risk-adjusted melphalan conditioning dose; all of which should be confirmed by 
      randomized controlled trials.
FAU - Saito, Mayuko
AU  - Saito M
AD  - First Department of Internal Medicine, Sapporo Medical University School of 
      Medicine.
FAU - Hayashi, Toshiaki
AU  - Hayashi T
FAU - Nojima, Masahiro
AU  - Nojima M
FAU - Ikeda, Hiroshi
AU  - Ikeda H
FAU - Tarasawa, Isao
AU  - Tarasawa I
FAU - Yasui, Hiroshi
AU  - Yasui H
FAU - Ishida, Tadao
AU  - Ishida T
FAU - Adachi, Masaaki
AU  - Adachi M
FAU - Imai, Kohzoh
AU  - Imai K
FAU - Shinomura, Yasuhisa
AU  - Shinomura Y
LA  - jpn
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Rinsho Ketsueki
JT  - [Rinsho ketsueki] The Japanese journal of clinical hematology
JID - 2984782R
SB  - IM
MH  - Adult
MH  - Amyloidosis/complications/*therapy
MH  - Heart Failure/*complications
MH  - Humans
MH  - Male
MH  - *Peripheral Blood Stem Cell Transplantation
MH  - Remission Induction
MH  - Transplantation, Autologous
EDAT- 2007/12/18 09:00
MHDA- 2008/02/22 09:00
CRDT- 2007/12/18 09:00
PHST- 2007/12/18 09:00 [pubmed]
PHST- 2008/02/22 09:00 [medline]
PHST- 2007/12/18 09:00 [entrez]
PST - ppublish
SO  - Rinsho Ketsueki. 2007 Nov;48(11):1478-83.