This Infoguide provides information about high-dose therapy and stem cell transplantation, one of the treatment options for AL amyloidosis.
Treatment of AL amyloidosis involves the use of chemotherapy, steroids and other drugs such as thalidomide, bortezomib (Velcade®) and lenalidomide (Revlimid®).
Standard chemotherapy, such as that used in combination with thalidomide and/or steroids is an effective way of treating AL amyloidosis.
However, a major drawback of chemotherapy is that it is not safe to give in high doses. This is because high doses of
chemotherapy kill the bloodforming stem cells in the bone marrow. This severely affects blood cell production, with blood counts falling to dangerously low levels.
High-dose therapy (HDT) and stem cell transplantation (SCT) offers a solution to this problem.
HDT-SCT involves giving high doses of chemotherapy to kill the abnormal plasma cells, and then giving back your own previously collected healthy stem cells. This effectively ‘rescues’ your bone marrow, allowing blood cell production to continue. This is called autologous stem cell transplantation.
HDT-SCT is a relatively intensive procedure with a number of potential risks. It is therefore not suitable for everyone. It is generally limited to patients under 70 years old, who are willing to undergo an intensive treatment, meet strict criteria
involving heart and kidney function and who have fewer than two organs affected by amyloid.
The whole process ofhigh-dose therapy and stem cell transplantation can take several months. The infuosheet goes into more detail about:
- HDT-SCT – the process
- Induction chemotherapy
- Stem cell mobilisation
- Collection and storage of stem cells
- Hospital admission and outpatient care
- Receiving the high-dose therapy
- Having your stem cells returned – the transplant
- Supportive care during recovery
- Continuing recovery and follow-up care