ArticleBlood advances2019
Primary treatment of light-chain amyloidosis with bortezomib, lenalidomide, and dexamethasone.
Article in Blood advances, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- The proteasome as a druggable target with multiple therapeutic potentialities: Cutting and non-cutting edges.Pharmacology & therapeutics · 2020Pooled it
- Improved survival with daratumumab-CyBorD compared with CyBorD as frontline therapy for AL amyloidosis.Blood neoplasia · 2025Trial
- Multimodality imaging features of systemic amyloidosis: a case report.BMC cardiovascular disorders · 2025Article
- Light-chain amyloidosis with dysphagia as the main symptom: a case report.Journal of medical case reports · 2024Article
- Uncovering the knowledge about systemic amyloidosis relevant to the rheumatologists.Advances in rheumatology (London, England) · 2024Review
- Morphological profiling in human neural progenitor cells classifies hits in a pilot drug screen for Alzheimer's disease.Brain communications · 2024Article
- Current progress in CAR-based therapy for kidney disease.Frontiers in immunology · 2024Review
- Monoclonal Gammopathy of Undetermined Cardiovascular Significance; Current Evidence and Novel Insights.Journal of cardiovascular development and disease · 2023Review
- The management of light chain (AL) amyloidosis in Europe: clinical characteristics, treatment patterns, and efficacy outcomes between 2004 and 2018.Blood cancer journal · 2023Observational
- Bad players in AL amyloidosis in the current era of treatment.Expert review of hematology · 2023Article
- Cardiovascular toxicity from therapies for light chain amyloidosis.Frontiers in cardiovascular medicine · 2023Review
- Diagnostic and Therapeutic Considerations in Concurrent Plasma Cell Dyscrasia and Amyloidosis.Qatar medical journal · 2022Article
- Outcomes of bortezomib combination chemotherapies in autologous stem cell transplantation-ineligible patients with AL amyloidosis.Blood research · 2021Article
- AL Amyloidosis: Current Chemotherapy and Immune Therapy Treatment Strategies:JACC. CardioOncology · 2021Review
- Current Updates on the Management of AL Amyloidosis.Journal of hematology · 2021Review
- Practical recommendations for the diagnosis and management of transthyretin cardiac amyloidosis.Heart failure reviews · 2021Review
- Updates in Cardiac Amyloidosis Diagnosis and Treatment.Current oncology reports · 2021Review
- Pharmacologic targeting of plasma cell endoplasmic reticulum proteostasis to reduce amyloidogenic light chain secretion.Blood advances · 2021Article
- Review
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Authors and funding
23 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bortezomib and dexamethasone with cyclophosphamide (CyBorD) or melphalan (BMDex) are commonly used primary treatments for light-chain (AL) amyloidosis, but limited data exist on bortezomib with immunomodulatory drug combinations. We report our experience with primary therapy with a bortezomib, lenalidomide, and dexamethasone (VRD) "light" regimen in 34 consecutive patients with AL amyloidosis. The majority (79%) had cardiac involvement, 15% and 23% were Mayo stage 3A and 3B, respectively, and 54% had renal involvement. After the first VRD cycle, 71% of patients achieved a hematologic response (44% at least very good partial response [VGPR]). On intent to treat, 11 (32%) achieved a complete response (of whom 5 of 11 were minimal residual disease [MRD] negative at 10-5), 17 (50%) a VGPR, and 2 (7%) a partial response. The 12-month survival was 73%. Starting lenalidomide dose was 5 mg in 86% of patients. Hematologic toxicity was mild; nonhematologic toxicities included rash (grade 3/4 [16%]), infections (grade ≥3 [12%]), constipation (grade ≥3 [9%]), and peripheral neuropathy (grade 2 [20%]); 37.5% of patients required lenalidomide dose reduction, 27% discontinued lenalidomide, 38% required bortezomib dose reduction, and 12% discontinued bortezomib. We compared VRD to CyBorD in 68 patients matched for Mayo stage and baseline difference between involved minus uninvolved serum free light chain levels, and observed a trend for deeper response at 3 and 6 months with VRD. In conclusion, VRD can be an active regimen for newly diagnosed patients with AL amyloidosis able to induce very deep hematologic responses at the expense of increased toxicity.
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