Amyloidosis Clinical Trial
Official title:
Induction Therapy With Bortezomib and Dexamethasone Followed by Autologous Stem Cell Transplantation Versus Autologous Stem Cell Transplantation Alone in the Treatment of AL Amyloidosis
This randomized phase III trial is studying the side effects and how well giving induction therapy with bortezomib and dexamethasone followed by autologous stem cell transplantation (ASCT) compared with ASCT alone in treating patients with newly diagnosed renal AL amyloidosis. In this prospective, randomized control study, patients with newly diagnosed AL amyloidosis who met the criteria for ASCT were randomized to receive 2 cycles of BD as induction therapy followed by ASCT (BD+ASCT) (arm 1) or to receive ASCT alone as an initial treatment (arm 2). Hematologic and organ responses were evaluated every 3 months after ASCT. All the patients should be followed up for 12 months.
Arm 1: The BD regimen included bortezomib 1.3 mg/m2 i.v. and dexamethasone 40 mg p.o. on
days 1, 4, 8 and 11 of the 21 day cycle. This process was repeated for 2 cycles. After two
cycles of BD therapy, the collection of peripheral blood stem cells (PBSC) should be
completed within 4 weeks. Recommended dose of drug is as follows: granulocyte
colony-stimulating factor (G-CSF) 5-10ug/kg on days 1-5 will be given, then peripheral blood
stem cells will be collected on days 5-6 for 2×10^6 CD34+ cells /kg. Patients will receive
ASCT therapy in 8 weeks after collection of PBSC (Recorded as day 0), while melphalan (day
-2) with a dose of 140 or 200 mg/m2 (choosing a dose according to the degree of risk for
patients). Melphalan will be administered by central venous catheter.
Arm 2: the patients who assigned to arm 2 will receive ASCT alone as an initial treatment.
The process of ASCT is as same as arm 1.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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