Predictors of survival in patients with systemic light-chain amyloidosis and cardiac involvement initially ineligible for stem cell transplantation and treated with oral melphalan and dexamethasone Academic Article uri icon


MeSH Major

  • Amyloidosis
  • Cardiomyopathies
  • Dexamethasone
  • Immunoglobulin Light Chains
  • Melphalan


  • The treatment of systemic light-chain (AL) amyloidosis with symptomatic cardiac involvement at diagnosis remains a challenge. We report the results of 40 consecutive newly diagnosed AL cardiac patients who were not candidates for stem cell transplant and therefore received monthly oral melphalan and dexamethasone. Median survival was 10.5 months and baseline predictors of survival included gender, troponin I and interventricular septal thickness. The most significant predictor of survival was response to therapy. The haematological response rate was 58% (23/40) with 13% (5/40) complete responses; most responses were noted in <3 cycles. Achievement of a rapid response to therapy extends survival.

publication date

  • November 2008



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1111/j.1365-2141.2008.07327.x

PubMed ID

  • 18691169

Additional Document Info

start page

  • 369

end page

  • 73


  • 143


  • 3