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Delayed autologous stem cell transplantation following cardiac transplantation experience in patients with cardiac amyloidosis.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2019 Oct; Vol. 19 (10), pp. 2900-2909. Date of Electronic Publication: 2019 Jul 01. - Publication Year :
- 2019
-
Abstract
- This study sought to retrospectively investigate the outcomes of patients with light-chain amyloidosis (AL) with advanced cardiac involvement who were treated with a strategy of heart transplantation (HT) followed by delayed autologous stem cell transplantation (ASCT) at 1-year posttransplant. Patients with AL amyloidosis with substantial cardiac involvement have traditionally had very poor survival (eg, several months). A few select centers have reported their outcomes for HT followed by a strategy of early ASCT (ie, 6 months) for CA. The outcomes of patients undergoing a delayed strategy have not been reported. All patients with AL amyloidosis at a single institution undergoing evaluation for HT from 2004-2018 were included. Retrospective analyses were performed. Sixteen patients underwent HT (including two combined heart-kidney transplant) for AL amyloidosis. ASCT was performed in a total of nine patients to date at a median 13.5 months (12.8-32.9 months) post-HT. Survival was 87.5% at 1 year and 76.6% at 5 years, comparable to institutional outcomes for nonamyloid HT recipients. In addition to these 16 patients, two patients underwent combined heart-lung transplantation. A strategy of delayed ASCT 1-year post-HT for patients with AL amyloidosis is feasible, safe, and associated with comparable outcomes to those undergoing an earlier ASCT strategy.<br /> (© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adult
Aged
Amyloidosis complications
Amyloidosis pathology
Amyloidosis therapy
Cardiomyopathies complications
Cardiomyopathies pathology
Cardiomyopathies therapy
Case-Control Studies
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Transplantation, Autologous
Treatment Outcome
Amyloidosis mortality
Cardiomyopathies mortality
Heart Transplantation mortality
Stem Cell Transplantation mortality
Time-to-Treatment statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 19
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 31152491
- Full Text :
- https://doi.org/10.1111/ajt.15487