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Induction Therapy with Bortezomib Cyclophosphamide Dexamethasone and Conditioning with Lenalidomide for Al Renal Amyloidosis: Long-Term Follow Up

Medicine Group    Start Submission

Greco Rosita*, Agata Mollica, Botta Cirino, Gentile Massimo, Enrica Martino and Papalia Teresa

Volume5-Issue2
Dates: Received: 2024-02-14 | Accepted: 2024-02-25 | Published: 2024-02-28
Pages: 214-220

Abstract

Objectives: In our study we evaluated the long term efficacy of protocol with bortezomib in induction and lenalidomide in maintenance for AL renal Amyloidosis transplant-ineligible patients. Methods. A prospective analysis of 16 transplant-ineligible patients with histological diagnosis of renal amyloidosis. All patients had overt nephrotic syndrome. Bortezomib-based (CyBorD) regimen was used for 9 cycles. The patients with PRR were treated with Lenalidomide and dexamethasone.

Results: The mean age was 63±7aa and 7/16 were males. The amyloid deposits were FLC k in 6/16 and lambda in 10/16. At onset the mean proteinuria was 13.1±3.6gr/24h with average MDRD of 37.2ml/min. At onset 3 patients had Myeloma. 3/16 patients died for cardiac arrhythmia. CyBorD regimen was completed in 13/16. After 9 CyBorD cycles: 3/13 showed a Complete Renal Response (CRR) and Hematological Response (CHR); 10/13 showed a Partial Renal Response (PRR) and Partial Hemathological Response (PHR), but one died for Sepsi. The 9 patients in PRR were treated with Lenalidomide. After median 6 cycles 7/9 showed a CRR and CHR. Haemodialysis was started in 2/9. All the patients with CRR have been in remission for 30 months on average. Conclusion. Maintenance therapy with Lenalidomide is effective for complete and sustained renal remission.

FullText HTML FullText PDF DOI: 10.37871/jbres1884


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Copyright

© 2024 Rosita G, et al. Distributed under Creative Commons CC-BY 4.0

How to cite this article

Rosita G, Mollica A, Cirino B, Massimo G, Martino E, Teresa P. Induction Therapy with Bortezomib Cyclophosphamide Dexamethasone and Conditioning with Lenalidomide for Al Renal Amyloidosis: Long-Term Follow Up. J Biomed Res Environ Sci. 2024 Feb 28; 5(2): 214-220. doi: 10.37871/jbres1884, Article ID: JBRES1884, Available at: https://www.jelsciences.com/articles/jbres1884.pdf


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