Transplantace srdce a následná léčba AL-amyloidózy

Title in English Heart transplantation and the subsequent treatment of AL amyloidosis
Authors

ADAM Zdeněk KREJČÍ Jan KREJČÍ Marta NĚMEC Petr ŠPINAROVÁ Lenka ŽAMPACHOVÁ Víta ČERMÁKOVÁ Zdeňka PIKA T. POUR Luděk KOŘÍSTEK Zdeněk TOMIŠKA Miroslav SZTURZ Petr KRÁL Zdeněk MAYER Jiří

Year of publication 2013
Type Article in Periodical
Magazine / Source Vnitřní lékařství
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.prolekare.cz/casopisy/vnitrni-lekarstvi/2013-2-6/transplantace-srdce-a-nasledna-lecba-al-amyloidozy-39956
Field Oncology and hematology
Keywords AL amyloidosis; high-dose chemotherapy; bortezomib; lenalidomide; cardiomyopathy; heart biopsy
Attached files
Description Summary: Severe damage to the heart caused by AL amyloid deposits is a contraindication of high-dose chemotherapy with autologous haematopoietic stem cell transplantation. Severe heart damage caused by AL amyloid results in frequent life-threatening complications, even during the course of the classical chemotherapy treatment and it often makes keeping to the treatment schedule impossible. Scheduling heart transplantation before the treatment of AL amyloidosis will significantly improve the patients’ overall condition and enable them to undergo the intensive AL amyloidosis treatment with the hope that a long-term complete remission may be achieved. Conclusion: It was beneficial to perform the heart transplantation first and to initiate the AL amyloidosis treatment no sooner than three months after the heart transplantation in patients with severe heart damage caused by AL amyloid deposits. If the patients are in a good clinical conditions, autologous haematopoietic stem cells can be harvested after the heart transplantation and high-dose chemotherapy can be offered to the patients. If this intensive treatment does not induce remission, it is necessary to apply additional alternative treatments.
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