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Light chain amyloidosis

Approximately 34,000 individuals are diagnosed with multiple myeloma (MM) in the United States each year, with a median age at diagnosis of 69 years. [1]

MM is the most common indication for hematopoietic cell transplantation (HCT) in the United States. Approximately 96% of transplants in patients with MM are autologous transplants. [2]

Initial treatment for patients with MM is typically a course of induction therapy, followed by autologous HCT in eligible patients. Allogeneic HCT for MM is generally reserved for patients with high-risk disease. Most allogeneic transplants are performed after an autologous HCT with reduced-intensity or non-myeloablative condtioning regimens. [2, 3]

Autologous HCT in amyloidosis has shown improved post-transplantation survival, including both early post-transplant mortality and 5-year survival. [4]

Recommended timing for transplant consultation

  • At diagnosis
  • At progression and/or relapse

References

  1. SEER Stat Fact Sheets: Myeloma. Accessed 9 March, 2018. Access
  2. D'Souza A, Fretham C. Current Uses and Outcomes of Hematopoietic Cell Transplantation (HCT): CIBMTR Summary Slides, 2017. Available at: http://www.cibmtr.org
  3. Kyle RA, Rajkumar SV. Multiple myeloma. Blood. 2008; 111(6): 2962-2972. Access
  4. D’Souza A, Dispenzieri A, Wirk B, et al. Improved Outcomes After Autologous Hematopoietic Cell Transplantation for Light Chain Amyloidosis: A Center for International Blood and Marrow Transplant Research Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2015;33(32):3741-3749. doi:10.1200/JCO.2015.62.4015. Access
  5. D’Souza A, Lacy M, Gertz M, et al. Long-term outcomes after autologous stem cell transplantation for patients with POEMS syndrome (osteosclerotic myeloma): a single-center experience. Blood. 2012;120(1):56-62. doi:10.1182/blood-2012-04-423178. Access
  6. NMDP and ASTCT Recommended Timing for Transplant Consultation. Download PDF 
  7. National Comprehensive Cancer Network. Multiple Myeloma. (Version 3.2023). Access