The Effect and Safety of Bortezomib in the Treatment of AL Amyloidosis: A Systematic Review and Meta-Analysis

  • Fengjuan Jiang
  • Jin Chen
  • Hui Liu
  • Lijuan Li
  • Wenli Lu
  • Rong Fu
Review Article

Abstract

Bortezomib began to be used in the treatment of light chain (AL) amyloidosis in recent years. We performed the first meta-analysis of randomized clinical trials and clinical controlled trials to evaluate the effect and safety of bortezomib treatment for AL amyloidosis. We conducted a search (until July 2016) in electronic databases (PubMed databases and the Cochrane Central Register of Controlled Trials bases from the year 2003). There were 205 records we searched and eight studies was included (n = 617 persons). We demonstrated that bortezomib treatment significantly improved overall response rate (ORR), complete response, a cardiac response rate, 2-year overall survival and the risk of neuropathy and reduced overall mortality compared to controls without bortezomib therapy. From the comparison and subgroup analysis of ORR between bortezomib group and no bortezomib group, the patients with bortezomib had a higher ORR, especially patients pretreated with bortezomib before high-dose melphalan followed by autologous stem cell transplant compared to no pretreatment. In addition, patients with bortezomib in standard dosage had significantly higher ORR. According to our results, bortezomib should be used in AL amyloidosis patients to improve response rate and survival rate and future relevant randomized controlled trials require to be performed.

Keywords

Light chain (AL) amyloidosis Bortezomib treatment Effect and safety 

Notes

Acknowledgements

We wish to acknowledge the Health Statistics for Tianjin Medical University. This work was supported by the National Natural Science Foundation of China (Grant nos. 81570106, 814000888, 81600093), the anticancer major special project of Tianjin (Grant nos. 12ZCDZSY18000), the Tianjin Municipal Natural Science Foundation (Grant nos. 14JCYBJC25400, 15JCYBJC24300), Tianjin Health and Family Planning Commision (Grant nos. 15KG150). Fengjuan Jiang received Postgraduate Innovation Fund of ‘13th Five-Year comprehensive investment’ award from Tianjin Medical University (YJSCX201717).

Author contribution statement

Concept (RF) and design of study (FJ). Acquisition of data (FJ, JC, HL), analysis and interpretation of data (FJ, JC, LL,WL). Revision and intellectual contribution (FJ, JC, LL, HL, RF). All authors approved the final version. Drafting the article or revising it critically for important intellectual (FJ, RF, LL,WL). Final approval of the version to be published (WL, RF, LL).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studides with human participants or animals performed by any of the authors.

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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Fengjuan Jiang
    • 1
    • 3
  • Jin Chen
    • 1
  • Hui Liu
    • 1
  • Lijuan Li
    • 1
    • 3
  • Wenli Lu
    • 2
  • Rong Fu
    • 1
    • 3
  1. 1.Department of HematologyTianjin Medical University General HospitalTianjinPeople’s Republic of China
  2. 2.Department of Health Statistics, School of Public HealthTianjin Medical UniversityTianjinPeople’s Republic of China
  3. 3.Department of Graduate SchoolTianjin Medical UniversityTianjinPeople’s Republic of China

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