Cor Vasa 2013, 55(5):e468-e473 | DOI: 10.1016/j.crvasa.2012.11.015

Heart transplantation for cardiac light chain amyloidosis with subsequent autologous stem cell transplantation

Tomáš Honek^a, Jan Krejčí^a,*, Lenka Špinarová^a, Petr Hude^a, Petr Němec^b, Zdeněk Adam^c, Alžběta Sirotková^d, Víta Žampachová^d, Jiří Vítovec^a

^a I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně, International Clinical Research Center, Brno, Česká republika

^b Centrum kardiovaskulární a transplantační chirurgie, International Clinical Research Center, Brno, Česká republika

^c Interní hematologická a onkologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice Brno, Brno, Česká republika

^d I. patologicko-anatomický ústav, Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

Our report describes a case of 57-year-old man with manifest heart failure on the basis of cardiac amyloidosis, which was detected by endomyocardial biopsy. Due to the heart failure, the patient was unable to undergo myeloablative therapy. We changed our previous decision for conservative therapy of heart failure and the patient underwent heart transplantation. Autologous stem cell transplantation was performed 6 months later. After the successful stem cell transplantation, the serum free light chain lambda levels promptly decreased. One year later, their levels started again to increase. Chemotherapy was therefore initiated. The patient has now completed the seventh cycle of chemotherapy in good condition. The graft function is normal and the latest endomyocardial biopsy revealed no amyloid.

Keywords: Amyloidosis; Autologous stem cell transplantation; Endomyocardial biopsy; Heart failure; Heart transplantation

Received: October 8, 2012; Revised: November 19, 2012; Accepted: November 20, 2012; Published: October 1, 2013  Show citation