AL Amyloidosis

While AL amyloidosis can be managed there are limited treatment options, which mainly depend on the clinical state of the patient. The goal of treatment is to decrease the abnormal white plasma cells, slow the production of abnormal light chains, and prevent further organ damage. Patients may relapse after treatment and need more than one line of treatment. Some treatment options are listed below. They are in no particular order: ^[1]2

• Monoclonal antibodies (mAbs) ³ Immunotherapy leverages your own immune system to fight cancer and other diseases. Monoclonal antibody-based therapy is one type of immunotherapy approved for the treatment of newly diagnosed AL amyloidosis. Monoclonal antibodies are highly targeted immune proteins that have been engineered to attach to particular proteins, and in the case of AL amyloidosis, directly target the amyloid fibrils and subsequently destroy the existing amyloid.

• Chemotherapy is used to stop cancerous cells from replicating, and is also used to treat multiple myeloma. Some versions of this treatment can also be used to stop abnormal proteins from producing dangerous build-up. After chemotherapy, you will have check-ups 1-2 times each year. Doctors will check for any signs that the AL amyloidosis may have returned. If it does return, you may need to begin chemotherapy again.

• Bone marrow transplants take and store healthy stem cells from your own body, which are then used to replace abnormal cells in your bone marrow that have been killed off by chemotherapy.

• Organ transplants can help patients whose organs have been badly affected by amyloid build-up.

• Targeted medications help to slow AL amyloidosis. Many of these treatments are also used for certain types of cancer. Additionally, drugs used for related diseases, such as multiple myeloma, are being studied to see how they may be able to help treat AL amyloidosis.

• Your doctor may also discuss using other treatments, or the possibility of being enrolled for treatment within a clinical trial.

Other treatments to help with symptoms of AL amyloidosis

• To boost the effect of chemotherapy you may be given steroids, which can also lessen your chances of having a bad reaction to treatment.

• If you have a weak heart or heart failure, you may need specific medicines. The risk of adverse events can make it more difficult to manage treatment.

• For kidney failure, you could need dialysis during the end-stage or be offered a kidney transplant, providing you are suited for the procedure. But this does not treat the underlying cause of your kidney failure – AL amyloidosis. So you may need to continue other treatment methods, such as chemotherapy, to ensure amyloid build-up does not cause further organ damage.

• Given that high salt levels are associated with high blood pressure and heart disease,⁴ your doctors and nurses will carefully moderate your salt intake.