The treatment of AL amyloidosis in the Netherlands in 2013: Adviezen van de HOVON-werkgroep Multipel Myeloom

Monique C. Minnema, Bouke Hazenberg, Alexandra J. Croockewit, Sonja Zweegman, Marie-Jose Kersten, Pieter Sonneveld, Peter A. Von dem Borne, Gerard Bos, Esther de Waal, Edo Vellenga, Henk M. Lokhorst

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Abstract

AL amyloidosis is the only form of amyloidosis caused by a small plasma cell clone in the bone marrow. The produced aberrant free light chain forms, together with serum amyloid P, deposits in several organs leading to organ dysfunction. Involvement of the heart is the most important prognostic factor. Treatment of systemic AL amyloidosis is based on treatments as used in multiple myeloma, however is much more complicated due to organ dysfunction and worse clinical condition of the patients. Aim of treatment is to achieve a complete haematological response. Organ responses can occur later on. High dose melphalan followed by stem cell transplantation is given to younger en fit patients. Older patients are treated with oral melphalan and dexamethasone. Bortezomib also seems to be well tolerated by patients and has good clinical efficacy. Several randomised phase III studies, such as the HOVON 104, have started to investigate superiority of treatment with proteasome inhibitors. Treatment of patients in clinical studies is highly recommended.
Translated title of the contributionThe treatment of AL amyloidosis in the Netherlands in 2013
Original languageDutch
Pages (from-to)165-179
Number of pages15
JournalNederlands Tijdschrift voor Hematologie
Volume10
Issue number5
Early online date1-Jul-2013
Publication statusPublished - 2013

Keywords

  • Hovon, AL amyloidosis, treatment

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