Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China
Objectives To compare the efficacy and safety of bortezomib with thalidomide and dexamethasone (BTD) and bortezomib with cyclophosphamide and dexamethasone (BCD) as the initial treatment for renal amyloid light chain (AL) amyloidosis in Chinese cohort.Methods A cohort of 174 patients with AL amyloid...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2453006 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849687572447494144 |
|---|---|
| author | Sheng Li Weiting He Hok-him Yau Jianteng Xie Yaxi Zhu Xiaojie Chen Shaogui Zhang Yifan Zhang Pengjun Liao Hui Liu Liwen Li Liye Zhong Wenjian Wang |
| author_facet | Sheng Li Weiting He Hok-him Yau Jianteng Xie Yaxi Zhu Xiaojie Chen Shaogui Zhang Yifan Zhang Pengjun Liao Hui Liu Liwen Li Liye Zhong Wenjian Wang |
| author_sort | Sheng Li |
| collection | DOAJ |
| description | Objectives To compare the efficacy and safety of bortezomib with thalidomide and dexamethasone (BTD) and bortezomib with cyclophosphamide and dexamethasone (BCD) as the initial treatment for renal amyloid light chain (AL) amyloidosis in Chinese cohort.Methods A cohort of 174 patients with AL amyloidosis was studied in Guangdong Provincial People’s Hospital from January 2008 to August 2023. Propensity-score matching cases were applied to assess the outcomes of patients treated with BTD and BCD regimen. Primary outcomes were patients achieving hematologic response and organ responses, and the secondary endpoints were patients progressing to end-stage renal disease or all-cause death.Results 44 Patients were included. The hematologic complete response rate (CR) in the BTD group was comparable between the groups of BTD group and BCD. However, the time to achieve hematologic CR was significantly shorter in the BTD group compared to the BCD group (4.97 vs. 7.71 mon, p = 0.010). Furthermore, when reaching hematologic response, the cumulative dose of bortezomib that standardized by body surface area (BSA) was lower in BTD group than in the BCD group (10.4 vs. 15.6 mg/m2, p = 0.013). There was no significant difference of renal and cardiac response between groups. However, post-treatment proteinuria levels after treatment were significantly lower in the BTD group compared to those in the BCD group (747 mg/24h vs. 2928 mg/24h, p = 0.048).Conclusions Compared to BCD regimen for renal AL amyloidosis, initial treatment with BTD regimen demonstrated similar rates of hematologic CR but showed superior reduction in proteinuria, reduced cumulative dose of bortezomib and faster time-to-response. |
| format | Article |
| id | doaj-art-0b10e7799eb34bd2988f6aa6017e9082 |
| institution | DOAJ |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-0b10e7799eb34bd2988f6aa6017e90822025-08-20T03:22:18ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2453006Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in ChinaSheng Li0Weiting He1Hok-him Yau2Jianteng Xie3Yaxi Zhu4Xiaojie Chen5Shaogui Zhang6Yifan Zhang7Pengjun Liao8Hui Liu9Liwen Li10Liye Zhong11Wenjian Wang12School of Medicine, South China University of Technology, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Hematopathology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDepartment of Hematopathology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaObjectives To compare the efficacy and safety of bortezomib with thalidomide and dexamethasone (BTD) and bortezomib with cyclophosphamide and dexamethasone (BCD) as the initial treatment for renal amyloid light chain (AL) amyloidosis in Chinese cohort.Methods A cohort of 174 patients with AL amyloidosis was studied in Guangdong Provincial People’s Hospital from January 2008 to August 2023. Propensity-score matching cases were applied to assess the outcomes of patients treated with BTD and BCD regimen. Primary outcomes were patients achieving hematologic response and organ responses, and the secondary endpoints were patients progressing to end-stage renal disease or all-cause death.Results 44 Patients were included. The hematologic complete response rate (CR) in the BTD group was comparable between the groups of BTD group and BCD. However, the time to achieve hematologic CR was significantly shorter in the BTD group compared to the BCD group (4.97 vs. 7.71 mon, p = 0.010). Furthermore, when reaching hematologic response, the cumulative dose of bortezomib that standardized by body surface area (BSA) was lower in BTD group than in the BCD group (10.4 vs. 15.6 mg/m2, p = 0.013). There was no significant difference of renal and cardiac response between groups. However, post-treatment proteinuria levels after treatment were significantly lower in the BTD group compared to those in the BCD group (747 mg/24h vs. 2928 mg/24h, p = 0.048).Conclusions Compared to BCD regimen for renal AL amyloidosis, initial treatment with BTD regimen demonstrated similar rates of hematologic CR but showed superior reduction in proteinuria, reduced cumulative dose of bortezomib and faster time-to-response.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2453006Light chain amyloidosisbortezomibcyclophosphamidethalidomidedexamethasone |
| spellingShingle | Sheng Li Weiting He Hok-him Yau Jianteng Xie Yaxi Zhu Xiaojie Chen Shaogui Zhang Yifan Zhang Pengjun Liao Hui Liu Liwen Li Liye Zhong Wenjian Wang Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China Renal Failure Light chain amyloidosis bortezomib cyclophosphamide thalidomide dexamethasone |
| title | Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China |
| title_full | Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China |
| title_fullStr | Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China |
| title_full_unstemmed | Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China |
| title_short | Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China |
| title_sort | outcomes of btd vs bcd as initial treatment of renal amyloid light chain amyloidosis a retrospective cohort study in china |
| topic | Light chain amyloidosis bortezomib cyclophosphamide thalidomide dexamethasone |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2453006 |
| work_keys_str_mv | AT shengli outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT weitinghe outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT hokhimyau outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT jiantengxie outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT yaxizhu outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT xiaojiechen outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT shaoguizhang outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT yifanzhang outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT pengjunliao outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT huiliu outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT liwenli outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT liyezhong outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina AT wenjianwang outcomesofbtdvsbcdasinitialtreatmentofrenalamyloidlightchainamyloidosisaretrospectivecohortstudyinchina |