Adding Cyclophosphamide to Bortezomib and Dexamethasone was not Associated With Improved Outcomes of Patients With Newly Diagnosed Light Chain Amyloidosis: A Retrospective Study.

Abstract

INTRODUCTION:

Before 2021, the combination of bortezomib, cyclophosphamide, and dexamethasone (VCd) was one of the most used upfront therapy for systemic immunoglobulin light chain (AL) amyloidosis. Recently, daratumumab in combination with VCd resulted in improved outcomes compared to VCd. However, it's still unclear the role of cyclophosphamide in this combination.

MATERIALS AND METHODS:

We conducted this retrospective single-institutional study to compare the outcomes of upfront bortezomib and dexamethasone with or without cyclophosphamide (VD vs. VCd).

RESULTS:

Of 136 total patients, 62 received VD and 74 received VCd. The median age was 64 and the median number of organs involved was 2. Hematologic response was achieved among 73.4% patients in the VD arm and 85.9% in the VCd arm at 3 months (P = .15). Best organ response was not different between 2 arms (34.1% vs. 52.9% for VD and VCd arms, respectively; P = .28). After a median follow-up of 24.4 months, 2-year OS for VD and VCd arm was 70.6% and 84.6% respectively. The median overall survival was 70 months for VD arm and not reached for VCd arm (P = .30). There was no statistically significant difference in median time to next therapy (9.3 vs. 13.5 months for VD and VCd arms, respectively. P = .99).

CONCLUSION:

the addition of cyclophosphamide to VD was not associated with improved outcomes of patients with AL amyloidosis in this retrospective study.

• Authors: Yumeng Zhang, Lauren Duncanson, Jason Brayer, Frederic Reu, Doris Hansen, Melissa Alsina, Taiga Nishihori, Jose Ochoa-Bayona, Hien Liu, Kenneth Shain, Zachary Thompson, Rachid Baz, Brandon Blue
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 22 Issue 8 Pg. e770-e776 (08 2022) ISSN: 2152-2669 [Electronic] United States
• PMID: 35504808 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2022. Published by Elsevier Inc.

Chemical References

• Bortezomib
• Dexamethasone
• Cyclophosphamide

Topics

• Amyloidosis (diagnosis)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bortezomib (therapeutic use)
• Cyclophosphamide (therapeutic use)
• Dexamethasone (therapeutic use)
• Humans
• Immunoglobulin Light-chain Amyloidosis (drug therapy)
• Middle Aged
• Retrospective Studies