Autologous stem cell transplantation vs bortezomib based chemotheraphy for the first‐line treatment of systemic light chain amyloidosis in the UK

Objectives The benefit of autologous stem cell transplantation (ASCT) in the treatment light chain (AL) amyloidosis requires re-evaluation modern era. This retrospective case-matched study compares ASCT to bortezomib for patients with AL amyloidosis. Methods Newly diagnosed treated or between 2001 and 2018 were identified. Patients excluded if time from diagnosis exceeded 12 months. matched on a 1:1 basis, using propensity-matched scoring approach. Results A total 136 propensity score-matched included (ASCT n = 68, 68). There was no significant difference overall survival at two years (P .908, HR: 0.95, CI: 0.41-2.20). For vs bortezomib: haematological response rate 6 months 90.6% 92.5%; organ months: cardiac (70.0% 54%, P > .999), renal (74% 24%, .463) liver (21% 22%, .048); median progression-free (50 42 .058, 0.61, 0.37-1.02) next (68 45 months, .145, 0.31-1.19). More required group compared 24 (41 23, Chi-squared .004) 48 (57 41, .004). Conclusions small suggests that there is clear advantage over therapy. prospective randomised controlled trial evaluating critically needed.