Evidence map›Paper›PMID 30397193›Full record

ArticleBlood cancer journal2018

Deferred autologous stem cell transplantation in systemic AL amyloidosis.

Richa Manwani, Ute Hegenbart, Shameem Mahmood, Sajitha Sachchithanantham, Charalampia Kyriakou, Kwee Yong, Rakesh Popat, Neil Rabin, Carol Whelan, Tobias Dittrich and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Blood cancer journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. The Clinical Characteristics and Prognosis of Chinese Patients with Light-Chain Amyloidosis: A Retrospective Multicenter Analysis.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2022
    Article
  7. Article
  8. Review
  9. Review
  10. Review
  11. Review
  12. Review
  13. Approach to a patient with cardiac amyloidosis.Journal of geriatric cardiology : JGC · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Richa ManwaniNational Amyloidosis Centre, University College London, London, UK.
Ute HegenbartMedical Department V, Amyloidosis Centre, University Hospital Heidelberg, Heidelberg, Germany.
Shameem MahmoodNational Amyloidosis Centre, University College London, London, UK.
Sajitha SachchithananthamNational Amyloidosis Centre, University College London, London, UK.
Charalampia KyriakouDepartment of Haematology, University College London Hospitals, London, UK.
Kwee YongDepartment of Haematology, University College London Hospitals, London, UK.
Rakesh PopatDepartment of Haematology, University College London Hospitals, London, UK.
Neil RabinDepartment of Haematology, University College London Hospitals, London, UK.
Carol WhelanNational Amyloidosis Centre, University College London, London, UK.
Tobias DittrichMedical Department V, Amyloidosis Centre, University Hospital Heidelberg, Heidelberg, Germany.
Christoph KimmichMedical Department V, Amyloidosis Centre, University Hospital Heidelberg, Heidelberg, Germany.
Philip HawkinsNational Amyloidosis Centre, University College London, London, UK.
Stefan SchönlandMedical Department V, Amyloidosis Centre, University Hospital Heidelberg, Heidelberg, Germany.
Ashutosh WechalekarNational Amyloidosis Centre, University College London, London, UK. a.wechalekar@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

High-dose melphalan with autologous stem cell transplantation (ASCT) can induce durable haematological and organ responses in systemic AL amyloidosis (AL). Stringent selection criteria have improved safety of ASCT in AL but most patients are transplant-ineligible. We report our experience of deferred ASCT in AL patients who were transplant-ineligible at presentation but had improvements in organ function after induction chemotherapy, enabling them to undergo ASCT. Twenty-two AL patients underwent deferred ASCT from 2011 to 2017. All had serial organ function and clonal response assessment. Organ involvement and responses were defined by amyloidosis consensus criteria. All patients were transplant-ineligible at presentation, predominantly due to advanced cardiac involvement. All received bortezomib-based therapy, with 100% haematologic response (86% complete response (CR)/very good partial response (VGPR)), enabling reversal of ASCT exclusion criteria. Patients underwent deferred ASCT for haematologic progression (45%) or consolidation (55%). There was no transplant-related mortality. Haematologic responses post-ASCT: CR 50%, VGPR 27%, PR 18%, non-response 5%. In all, 85.7% achieved cardiac responses. Median overall survival (OS) was not reached. Median progression-free survival (PFS) was 54 months. This selected cohort achieved excellent haematologic responses, organ responses, PFS and OS with deferred ASCT. If larger studies confirm these findings, this may widen the applicability of ASCT in AL.

Indexed as

Hematopoietic Stem Cell TransplantationAdultAgedBiomarkersFollow-Up StudiesHumansImmunoglobulin Light-chain AmyloidosisMiddle AgedPrognosisSeverity of Illness IndexTransplantation, AutologousTreatment OutcomeBiomarkers

Identifiers

PMID30397193
PMCPMC6218452

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.