| Abstract: |
The treatment for immunoglobin light-chain amyloidosis has included high-dose chemotherapy with stem cell transplantation. This effective technique is only applicable to approximately 20% of patients. Standard dose chemotherapy has included melphalan with dexamethasone. This regimen results in response rates in excess of 50%. With the introduction of IMID therapy, the combination of thalidomide or lenalidomide with dexamethasone has produced respectable response rates, but tolerance of patients with amyloidosis to IMID's is less than in patients with multiple myeloma. The introduction of bortezomib for the management of light-chain amyloidosis is reviewed in this chapter. Bortezomib is highly active both as a single agent and in combination with corticosteroids in the treatment of immunoglobulin light-chain amyloidosis, with high hematologic and organ response rates reported. The agent can be used with renal insufficiency, including dialysis dependence. The agent has not been extensively tested in patients with class 3-4 heart failure. © Springer Basel AG 2011. |
