Nephrotic Syndrome Due to Primary AL Amyloidosis, Successfully Treated with VAD and Subsequent High-dose Melphalan Followed by Autologous Peripheral Blood Stem Cell Transplantation

Takahisa GONO; Masayuki MATSUDA; Naoko Dohi; Kenichi Hoshi; Tsuyoshi TADA; Kazuo SAKASHITA; Kenichi KOIKE; Masatsugu AlZAWA; Shu-ichi IKEDA

doi:10.2169/internalmedicine.42.72

Takahisa GONO, Masayuki MATSUDA, Naoko Dohi, Kenichi Hoshi, Tsuyoshi TADA, Kazuo SAKASHITA, Kenichi KOIKE, Masatsugu AlZAWA, Shu-ichi IKEDA

Author information

Takahisa GONO
The Third Department of Medicine, Shinshu University School of Medicine
Masayuki MATSUDA
The Third Department of Medicine, Shinshu University School of Medicine
Naoko Dohi
The Third Department of Medicine, Shinshu University School of Medicine
Kenichi Hoshi
The Third Department of Medicine, Shinshu University School of Medicine
Tsuyoshi TADA
The Department of Neurosurgery, Shinshu University School of Medicine
Kazuo SAKASHITA
The Department of Pediatrics, Shinshu University School of Medicine
Kenichi KOIKE
The Department of Pediatrics, Shinshu University School of Medicine
Masatsugu AlZAWA
The Department of Medicine, Fuji Hospital
Shu-ichi IKEDA
The Third Department of Medicine, Shinshu University School of Medicine

Keywords: M protein, plasma cell dyscrasia, chemotherapy

JOURNAL FREE ACCESS

2003 Volume 42 Issue 1 Pages 72-77

DOI https://doi.org/10.2169/internalmedicine.42.72

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Abstract

Primary AL amyloidosis involves vital organs from the early phase of illness, resulting in a poor prognosis. We report a patient with nephrotic syndrome due to this type of amyloidosis, who was successfully treated with two courses of VAD (vincristine, doxorubicin and dexamethasone) and subsequent high-dose melphalan (140 mg/m²) with autologous stem cell support. Following the serial chemotherapy his proteinuria improved, and M protein became undetectable in both serum and urine. To avoid the progression of primary AL amyloidosis, intensive chemotherapy should be actively used when the general status and vital organ functions are well preserved.
(Internal Medicine 42: 72-77, 2003)

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