Autologous Stem Cell Transplantation in Patients with AL Amyloidosis with Impaired Renal Function

Abstract

Background Patients with immunoglobulin light chain (AL) amyloidosis often present with organ dysfunction secondary to the deposition and aggregation of the amyloidogenic light chain. Renal involvement typically presents as proteinuria, however renal dysfunction manifesting as reduced creatinine clearance (CrCL) may also be seen, often contributed to by other comorbidities and can complicate therapy for these patients. Patients and methods We retrospectively reviewed all patients receiving an autologous stem cell transplant (ASCT) for AL amyloidosis at the Mayo Clinic Rochester between 19th May 1999 and 30th of September 2017, to identify the impact of impaired renal function (CrCL Results Baseline characteristics for each cohort are summarized in Table 1. Median age and the proportion of males in each cohort were similar. Predictably renal amyloidosis was more common in the IRF group (90% IRF cohort vs 60% NRF cohort, p Conclusions ASCT is an effective therapy in patients with AL amyloidosis and impaired renal function. Although PFS and OS in this cohort are similar to those with normal renal function, the 100 day mortality and proportion of patients requiring dialysis post ASCT are higher and need to be considered prior to recommendation of this therapy for patients.