{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:19:29Z","timestamp":1783117169391,"version":"3.54.6"},"reference-count":52,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>High dose melphalan (HDM) with autologous stem cell transplant is an established treatment for systemic light chain amyloidosis, but its incremental benefit in the era of effective standard intensity therapy is unknown. We retrospectively analyzed 475 transplant\u2010eligible patients who completed standard intensity treatment with or without HDM within 12\u2009months at six centers in Europe and the United States between 2010 and 2024 to evaluate outcomes by baseline risk factors, hematologic response, and receipt of HDM. Death was an equally competing risk after the 12\u2010month landmark chosen to address early non\u2010proportional hazards and to ensure completion of first\u2010line therapy. BMPC &gt;\u200920% was associated with inferior outcomes (HR 1.7), and gain\/amp 1q with shorter TTP (HR 2.15), whereas other high\u2010risk FISH abnormalities were not. In multivariable models, VGPR\/CR after standard intensity therapy was associated with longer TTP (HR 0.49\/0.29), while gain\/amp 1q remained independently associated with shorter TTP (HR 2.18). Receipt of daratumumab and HDM were associated with longer TTP (HR 0.44\/0.61). HDM benefited patients who had not achieved CR after standard intensity therapy (mTTP 21.0 vs. 5.7\u2009months without HDM), whereas patients already in CR did not benefit. Higher BMPC at diagnosis was associated with earlier progression in patients not receiving HDM (HR 1.9 for 5%\u201320% and 4.09 for &gt;\u200920%), a risk attenuated in the HDM cohort. Gain\/amp 1q remained associated with shorter TTP regardless of HDM exposure. These findings support a selective role for HDM, primarily benefiting patients with residual disease after standard intensity therapy or higher BMPC burden at diagnosis.<\/jats:p>","DOI":"10.1002\/ajh.70371","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T03:55:16Z","timestamp":1780890916000},"page":"1903-1914","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Long\u2010Term Benefit From High Dose Melphalan With Autologous Stem Cell Transplant in\n                    <scp>AL<\/scp>\n                    Amyloidosis"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3644-9187","authenticated-orcid":false,"given":"Maximilian J.","family":"Steinhardt","sequence":"first","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Internal Medicine II University Hospital of W\u00fcrzburg  W\u00fcrzburg Germany"},{"name":"Interdisciplinary Amyloidosis Center University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6746","authenticated-orcid":false,"given":"Ute","family":"Hegenbart","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V, Amyloidosis Center Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Hellou","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Oubari","sequence":"additional","affiliation":[{"name":"Department of Hematology and Stem Cell Transplantation University Hospital Essen  Essen Germany"},{"name":"West German Amyloidosis Center University Hospital Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4045-9428","authenticated-orcid":false,"given":"Murielle","family":"Roussel","sequence":"additional","affiliation":[{"name":"Department of Hematology CHU Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahel","family":"Schwotzer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Haematology University Hospital of Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Buadi","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dingli","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Binder","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taxiarchis","family":"Kourelis","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh S.","family":"Zanwar","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8441-4547","authenticated-orcid":false,"given":"Max J.","family":"Rieger","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Haematology University Hospital of Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Morbach","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4393-1772","authenticated-orcid":false,"given":"Vladimir","family":"Cejka","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Gerber","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Haematology University Hospital of Zurich  Z\u00fcrich Switzerland"},{"name":"Universit\u00e0 Della Svizzera Italiana  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Center University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Einsele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II University Hospital of W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaji","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3853-5196","authenticated-orcid":false,"given":"Morie","family":"Gertz","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Carpinteiro","sequence":"additional","affiliation":[{"name":"Department of Hematology and Stem Cell Transplantation University Hospital Essen  Essen Germany"},{"name":"West German Amyloidosis Center University Hospital Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Martin","family":"Kortum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II University Hospital of W\u00fcrzburg  W\u00fcrzburg Germany"},{"name":"Interdisciplinary Amyloidosis Center University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-2174","authenticated-orcid":false,"given":"Eli","family":"Muchtar","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Hematology Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Dispenzieri","sequence":"additional","affiliation":[{"name":"Department of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sch\u00f6nland","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V, Amyloidosis Center Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-08-662726"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.62.4015"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2017.05.020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.53"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26641"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2021.2002841"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070484"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2020.11.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.9554"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.14.3350"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004463"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.108191"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2028631"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023022937"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2025016586"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.5724"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2020.04.024"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14830"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-019-0655-x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.20070"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024025899"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/13506129.2013.854766"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-025-06256-7"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-10-676361"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-023-00945-0"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2018.07.292"},{"issue":"2","key":"e_1_2_10_28_1","article-title":"Summary of the EHA\u2010ISA Working Group Guidelines for High\u2010Dose Chemotherapy and Stem Cell Transplantation for Systemic AL Amyloidosis","volume":"6","author":"Sanchorawala V.","year":"2022","journal-title":"Hema"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2022.2093635"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.7614"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20381"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02614"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-020-01136-2"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2016.1258356"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25572"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-020-00355-6"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2020.1802713"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00428-0"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-020-0291-8"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023022399"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002219"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-01-330738"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.06.018"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.06.027"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-020-00354-7"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01535-z"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12673"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.181339"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2022.2115353"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204925"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2022.08.009"},{"issue":"3","key":"e_1_2_10_52_1","article-title":"Genomics Define Malignant Transformation in Myeloma Precursor Conditions","volume":"44","author":"Maura F.","year":"2025","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.TPS7575"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajh.70371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:44:43Z","timestamp":1783115083000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.70371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,7]]},"references-count":52,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ajh.70371"],"URL":"https:\/\/doi.org\/10.1002\/ajh.70371","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,7]]},"assertion":[{"value":"2026-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}