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Carfilzomib is an effective upfront treatment in AL amyloidosis patients with peripheral and autonomic neuropathy
Author(s) -
Manwani Richa,
Mahmood Shameem,
Sachchithanantham Sajitha,
Lachmann Helen J.,
Gillmore Julian D.,
Yong Kwee,
Rabin Neil,
Popat Rakesh,
Kyriakou Charalampia,
Worthington Sarah,
Sharpley Faye,
Smith Mark,
Shah Raakhee,
Cheesman Simon,
Hawkins Philip N.,
Wechalekar Ashutosh D.
Publication year - 2019
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.16122
Subject(s) - carfilzomib , medicine , bortezomib , peripheral neuropathy , amyloidosis , al amyloidosis , incidence (geometry) , autonomic neuropathy , oncology , multiple myeloma , endocrinology , immunology , antibody , immunoglobulin light chain , diabetes mellitus , physics , genetics , biology , cell culture , optics , neuroblastoma
Summary Bortezomib is standard treatment in AL amyloidosis (AL), but is contraindicated in patients with significant neuropathy. Carfilzomib, a second‐generation proteosomal inhibitor, results in a lower incidence of neuropathy than bortezomib, but data in AL is scant. We report a cohort of five AL patients treated with upfront carfilzomib. All had cardiac, peripheral and autonomic neuropathy at presentation. All achieved at least a very good partial haematological response. There was no worsening in cardiac function, peripheral or autonomic neuropathy. Carfilzomib is an effective upfront treatment option in AL patients with peripheral and/or autonomic neuropathy (without severe cardiac or renal involvement).