Guidelines for high dose chemotherapy and stem cell transplantation for systemic AL amyloidosis: EHA-ISA working group guidelines

Amyloid. 2022 Mar;29(1):1-7. doi: 10.1080/13506129.2021.2002841. Epub 2021 Nov 16.


AL amyloidosis is a systemic amyloidosis and is associated with an underlying plasma cell dyscrasia. High dose intravenous melphalan and autologous stem cell transplantation was developed for the treatment of AL amyloidosis in the early 1990s and was prompted by its success in multiple myeloma. This application has evolved significantly over the past three decades. These guidelines provide a comprehensive assessment of eligibility criteria, stem cell collection and mobilisation strategies and regimens, risk-adapted melphalan dosing, role for induction and consolidation therapies, specific supportive care management, long-term outcome with respect to survival, haematologic response and relapse and organ responses following stem cell transplantation. These guidelines are developed by the experts in the field on behalf of the stem cell transplant working group of the International Society of Amyloidosis (ISA) and European Haematology Association (EHA).

Keywords: AL amyloidosis; melphalan; patient selection; stem cell transplantation; supportive care.

MeSH terms

  • Amyloidosis* / complications
  • Amyloidosis* / drug therapy
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / complications
  • Immunoglobulin Light-chain Amyloidosis* / drug therapy
  • Melphalan / therapeutic use
  • Neoplasm Recurrence, Local / complications
  • Neoplasm Recurrence, Local / drug therapy
  • Stem Cell Transplantation / methods
  • Transplantation, Autologous
  • Treatment Outcome


  • Melphalan