Novel Approaches for the Management of AL Amyloidosis

Curr Hematol Malig Rep. 2018 Jun;13(3):212-219. doi: 10.1007/s11899-018-0450-1.

Abstract

Purpose of review: Light-chain-associated (AL) amyloidosis is a rare disease with a poor prognosis. However, we have made recent strides in more accurate diagnosis and effective treatment. Here, we discuss the most recent updates and advancements during the past year in the diagnosis, prognostication, and management of AL amyloidosis both in the upfront and relapsed setting.

Recent findings: New imaging modalities, such as cardiac magnetic resonance (CMR) and use of fluorine-labeled radiotracers, are emerging as an important diagnostic tool in conjunction with biomarkers in the diagnosis, prognosis, and monitoring of the effects of therapy. In addition, ongoing evaluation of plasma cell-directed therapeutics, including daratumumab, pomalidomide, and ixazomib, as well as promising targeted novel therapies, such as the monoclonal antibody NEOD001, are in development. In conclusion, incorporating the use of plasma cell-directed therapy and novel agents targeting the amyloid deposits itself hold enormous potential in achieving improved outcomes in AL amyloidosis.

Keywords: Amyloid; Biomarkers; Light chain type; Plasma cell disorder; Systemic.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Boron Compounds / therapeutic use*
  • Glycine / analogs & derivatives*
  • Glycine / therapeutic use
  • Humans
  • Immunoglobulin Light-chain Amyloidosis* / diagnosis
  • Immunoglobulin Light-chain Amyloidosis* / diagnostic imaging
  • Immunoglobulin Light-chain Amyloidosis* / drug therapy
  • Magnetic Resonance Imaging*
  • Prognosis
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Boron Compounds
  • daratumumab
  • Thalidomide
  • ixazomib
  • pomalidomide
  • Glycine
  • birtamimab