A modified high-dose dexamethasone regimen for primary systemic (AL) amyloidosis

High-dose dexamethasone (HD-Dex) has been reported to benefit AL amyloidosi s patients with varying response rates. Our preliminary experience with the usual HD-Dex schedule indicated that the induction phase was rather toxic in AL patients, We therefore adopted a milder schedule consisting of dexame thasone 40 mg on d 1-4 q21 d for up to eight cycles. Overall 8 out of 23 (3 5%) treated patients responded to treatment in a median time of 4 months (r ange 2-6 months) without significant toxicity. This regimen may be consider ed front-line therapy when autologous stem cell transplantation is not feas ible and when a rapid response is particularly important.