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Bortezomib induction and SCT in AL amyloidosis
Figure 2. Response rates following the initiation of treatment. The upper line represents the time to first response, defined as partial response or better, while the lower line represents the time to first complete response. PR: partial response; CR: complete response.
Figure 3. Organ responses depicted separately for patients who proceeded to autologous stem cell transplantation or not. Organ responses were assessed according to consensus criteria after induction and as best responses achieved during study treatment and follow-up. Auto-SCT: autologous stem cell transplan- tation.
Figure 4. Overall and progression-free survival of the total cohort of patients and the 35 patients who underwent autologous stem cell transplantation. (A) Progression-free and overall survival from date of registration in the trial for the 50 patients included. (B) Progression-free survival from autologous stem cell trans- plantation of the 35 transplanted patients according to response achieved after induction therapy. PFS: progression-free survival; OS: overall survival; PR: partial remission; VGPR: very good partial remission.
kidney responses improved from 24% to 69% at 2 years after auto-SCT and that of cardiac responses from 24% to 78%. In intention-to-treat analysis 61% of patients achieved a renal response, 72% a cardiac response and 62% a liver response. During the HDM and auto-SCT procedure two patients had a deterioration of their renal function, defined as a decrease of 25% in eGFR, which persisted during the follow-up. The median time to first organ response was 222 days for the heart (IQR, 125-395) and 318 days (IQR 91-615) for the kidney. Organ progres- sion was seen in six of 33 patients with cardiac involve-
ment, 13 out of 41 patients with kidney involvement, and three of 13 patients with liver involvement.
During the study new renal response criteria were developed (≥30% decrease in proteinuria or drop of pro- teinuria <0.5 g/day in the absence of renal progression, defined as a ≥25% decrease in eGFR). According to these criteria 14 patients (48%) who proceeded to auto-SCT had a renal response after induction treatment and this increased to 22 patients (76%) after auto-SCT (Figure 3).
Patients with a deep hematologic response (CR/VGPR) at 6 months after auto-SCT and at subsequent time-
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