Autologous Peripheral Blood Stem Cell Transplantation With High Dose Melphalan For Treatment Of Primary Amyloidosis (AL)

Fecha de inicio: 1 de mayo de 1996

DISEASE CHARACTERISTICS: Primary amyloidosis diagnosed by appropriate amyloid stains or electromicroscopy of abdominal fat, bone marrow, or other target tissues Pathology reviewed by Temple University Amyloidosis secondary to any stage of multiple myeloma allowed provided plasma cell concentration in bone marrow is less than 15% No amyloidosis secondary to rheumatoid arthritis or chronic infection No familial amyloidosis PATIENT CHARACTERISTICS: Age: 16 to 65 Performance status: Karnofsky 80-100% Hematopoietic: Not specified Hepatic: Liver function tests less than twice normal No active liver disease Renal: Creatinine clearance greater than 50 mL/min Nephrotic syndrome allowed Cardiovascular: Cardiac evaluation required in patients with left ventricular ejection fraction less than 45% by echocardiogram or MUGA No poorly controlled hypertension Pulmonary: FEV_1 and DLCO greater than 50% of predicted, or pulmonary evaluation required No chronic obstructive pulmonary disease Other: No history of serious coagulopathy, hemorrhage, or bleeding No active infection No other serious comorbid disease (e.g., poorly controlled diabetes) No pregnant women Adequate contraception required of fertile women PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: More than 12 monthly cycles of prior alkylating agent chemotherapy discouraged Endocrine therapy: Corticosteroids discontinued at least 6 weeks prior to transplantation Radiotherapy: No prior radiotherapy Surgery: Not specified