Primary Treatment of Light Chain (AL) Amyloidosis With Bortezomib, Lenalidomide and Dexamethasone (VRD) or with Bortezomib, Cyclophosphamide and Dexamethasone (VCD/CyBorD): efficacy and toxicity

BackgroundLimited data exist regarding efficacy and toxicity of VRD in newly diagnosed AL patients and especially compared to CyBorD which is the most commonly used regimen in this settingMethodswe compared the outcomes of 34 consecutive patients treated with VRD to a group of patients treated with CyBorD in our department, matched for Mayo stage, NTproBNP levels and baseline dFLC levels (1: 2 matching, N= 68 subjects treated with CyBorD). VRD included SQ bortezomib (1.3 mg/m2 days 1, 8 & 15), lenalidomide (starting at 5 to 15 mg on days 1-21) and dexamethasone 20 mg weekly, every 28 days for 8 cycles. Lenalidomide started at 5 mg in patients with any of the following: eGFR< 50 ml/min, heavy proteinuria with low serum albumin (< 2.5 gr/dl), age> 75 years, Mayo stage 2 with NTproBNP> 4000 pg/ml or Mayo stage 3 disease: starting dose was 5 mg in 30 (86%), 10 mg in 2 (7%) and 15 mg in 2 …