Dexamethasone is associated with early deaths in light chain amyloidosis patients with severe cardiac involvement.

PloS One
Mélanie BézardThibaud Damy


Cardiac light chain amyloidosis (AL-CA) patients often die within three months of starting chemotherapy. Chemotherapy for non-immunoglobulin M gammopathy with AL-CA frequently includes bortezomib (Bor), cyclophosphamide (Cy), and dexamethasone (D). We previously reported that NT-ProBNP levels can double within 24h of dexamethasone administration, suggesting a deleterious impact on cardiac function. In this study, we evaluate the role of dexamethasone in early cardiovascular mortality during treatment. We retrospectively assessed 100 de novo cardiac AL patients (62% male, mean age 68 years) treated at our institute between 2009 and 2018 following three chemotherapy regimens: CyBorDComb (all initiated on day 1; 34 patients), DCyBorSeq (D, day 1; Cy, day 8; Bor, day 15; 17 patients), and CyBorDSeq (Cy, day 1; Bor, day 8; D, day 15; 49 patients). The primary endpoint was cardiovascular mortality and cardiac transplantation at days 22 and 455. At day 22, mortality was 20.6% with CyBorDComb, 23.5% with DCyBorSeq, and 0% with CyBorDSeq (p = 0.003). At day 455, mortality was not significantly different between regimens (p = 0.195). Acute toxicity of dexamethasone was evaluated on myocardial function using a rat model of isolated perfus...Continue Reading


Nov 14, 1997·The American Journal of Cardiology·B ChamarthiR H Falk
May 19, 2000·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·F J Sutherland, D J Hearse
Jul 10, 2001·British Journal of Haematology·G PalladiniG Merlini
Sep 15, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Angela DispenzieriAllan S Jaffe
Nov 2, 2006·American Journal of Physiology. Endocrinology and Metabolism·Dake Qi, Brian Rodrigues
Jul 7, 2007·British Journal of Haematology·Martin KropffUNKNOWN Deutsche Studiengruppe Multiples Myelom,
Aug 31, 2011·Circulation·Rodney H Falk
Feb 15, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Shaji KumarMorie A Gertz
Sep 19, 2012·Circulation·C Cristina QuartaRodney H Falk
Oct 15, 2014·British Journal of Haematology·Julian D GillmoreGuy Pratt
Jan 1, 2015·European Heart Journal·Rabya H SayedJulian D Gillmore
Sep 17, 2015·Current Cardiology Reports·Michael N VranianMazen Hanna
Sep 17, 2016·Journal of the American College of Cardiology·Rodney H FalkSharmila Dorbala
Oct 21, 2016·Molecular and Cellular Biochemistry·Fabiana de Salvi GuimarãesAlessandra Medeiros
Mar 24, 2017·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Fabien Le BrasThibaud Damy
Sep 30, 2018·Leukemia·Jithma P AbeykoonPrashant Kapoor

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