• Michael Ozga, Qiuhong Zhao, Don Benson, Patrick Elder, Nita Williams, Naresh Bumma, Ashley Rosko, Maria Chaudhry, Abdullah Khan, Srinivas Devarakonda, Rami Kahwash, Ajay Vallakati, Courtney Campbell, Samir V Parikh, Salem Almaani, Jason Prosek, Jordan Bittengle, Katherine Pfund, Samantha LoRusso, Miriam Freimer, Elyse Redder, Yvonne Efebera, and Nidhi Sharma.
• Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA.
• J Clin Med. 2020 Nov 23; 9 (11).

BackgroundAutologous stem cell transplantation (ASCT) remains an effective treatment option for many patients with systemic light chain (AL) amyloidosis. While maintenance post ASCT in multiple myeloma is now standard, the decision to utilize maintenance in AL amyloidosis remains largely unexplored. The present study aims to determine the prognostic significance of utilizing maintenance therapy following ASCT and assess the impact of fluorescent in situ hybridization (FISH) abnormalities, bone marrow plasma cell burden (BMPC), and degree of organ involvement on this decision.Methods And ResultsThis is a retrospective analysis of fifty AL amyloidosis patients who underwent ASCT at The Ohio State University. Twenty-eight patients received maintenance and twenty-two did not. Kaplan-Meier survival analysis was used to compare the effect of maintenance therapy with no significant difference in PFS (p = 0.66) and OS (p = 0.32) between the two groups. There was no difference in survival based on maintenance when further categorized by FISH, PFS (p = 0.15), and OS (p = 0.65); BMPC ≥ 10%, PFS (p = 0.49), and OS (p = 0.32); or with 2 or more organs involved, PFS (p = 0.34) and OS (p = 0.80).ConclusionMaintenance therapy post ASCT did not impact PFS or OS when categorized by FISH abnormalities, increasing BMPC, or ≥2 organs involved in AL amyloidosis patients.

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