Systemic Amyloidosis due to Monoclonal Immunoglobulins, An Issue of Hematology/Oncology Clinics of North America

1st Edition, Volume 34-6 - October 27, 2020
Editor: Raymond L. Comenzo
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 1 6 5 - 6
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 1 6 6 - 3

This issue of Hematology/Oncology Clinics, Guest Edited by Dr. Raymond L. Comenzo, is devoted to Systemic Amyloidosis due to Monoclonal Immunoglobulins. This issue is one of six… Read more

Systemic Amyloidosis due to Monoclonal Immunoglobulins, An Issue of Hematology/Oncology Clinics of North America

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This issue of Hematology/Oncology Clinics, Guest Edited by Dr. Raymond L. Comenzo, is devoted to Systemic Amyloidosis due to Monoclonal Immunoglobulins. This issue is one of six selected each year by our series Consulting Editors, George P. Canellos and Edward J. Benz. Topics discussed in this important issue include: The Spectrum of Monoclonal Immunoglobulin Diseases, Systemic Amyloidosis due to Clonal Plasma Cell Diseases, Systemic Amyloidosis due to Low-grade Lymphomas, The Process of Amyloid Formation due to Monoclonal Immunoglobulins, Cardiac Involvement, Renal Involvement, Liver and Gastrointestinal Involvement, Peripheral Nervous System Involvement, Options for Chemotherapy, Stem-cell Mobilization and Autologous Transplant, Monoclonal Antibody Therapies, Solid Organ Transplant, Supportive Care, Patient Voices, and Future Perspectives.

Cover image
Title page
Table of Contents
Copyright
Contributors
Hematology/Oncology Clinics of North America
Preface
Introduction
The Spectrum of Monoclonal Immunoglobulin-Associated Diseases
Introduction and background
Nonamyloid, monoclonal gammopathies of renal significance
Nonamyloid, monoclonal gammopathy of neurologic significance
Nonamyloid, monoclonal gammopathy of cutaneous significance
Summary
Clinics care points
Systemic Amyloidosis Due to Clonal Plasma Cell Diseases
Key points
Introduction
Etiology
Pathogenesis
Epidemiology
Risk factors
Immunoglobulin light chain amyloidosis genetics and biology
Light chain amyloidosis plasma cells immunophenotype
Clinical presentation
Diagnosis
Staging and prognostic factors
Treatment considerations
Discussion
Summary
Clinics care points
Systemic Amyloidosis due to Low-Grade Lymphoma
Key points
Introduction
Clinical features of lymphoma-related amyloidosis
Treatment of immunoglobulin M–related AL amyloidosis
Response assessment and goals of treatment
Summary
The Process of Amyloid Formation due to Monoclonal Immunoglobulins
Key points
Introduction
From soluble immunoglobulins to insoluble amyloid fibrils
Sequence determinants of amyloid formation
Posttranslational factors affecting amyloid formation
Interaction with other tissue components affects amyloid fibril formation
Therapeutic options
Summary
Clinics care points
Systemic Amyloidosis due to Monoclonal Immunoglobulins: Cardiac Involvement
Key points
Introduction
Epidemiology
Delayed diagnosis
Pathophysiology
Diagnosis
Staging of disease with biomarkers
The role of qualitative echocardiographic assessments in prognosis
Advanced imaging approaches
Treatment
Summary
Renal Involvement in Systemic Amyloidosis Caused by Monoclonal Immunoglobulins
Key points
Introduction
Epidemiology
Pathogenesis
Clinical presentation
Diagnosis and pathology of renal amyloidosis
Summary
Liver and Gastrointestinal Involvement
Key points
Case 1
Liver involvement
Case 2
Gastrointestinal involvement
Summary
clinics care points
Peripheral Nervous System Involvement
Key points
Introduction
Light chain amyloid neuropathy
Light chain amyloid myopathy
Treatment and prognosis
Clinics care points
Systemic Amyloidosis Caused by Monoclonal Immunoglobulins: Soft Tissue and Vascular Involvement
Key points
Introduction
Discussion
Summary
Clinics care points
Options for Chemotherapy and Scoring Response and Relapse
Key points
Introduction
Alkylating agents
Proteasome Inhibitors
Immunomodulators
Small molecule: Venetoclax
Monoclonal antibodies
Prognostic models, staging, response, and progression
Summary
Stem Cell Mobilization and Autologous Transplant for Immunoglobulin Light-Chain Amyloidosis
Key points
Background
Prognosis
Outcomes
Summary
Clinics care points
Monoclonal Antibody Therapies in Systemic Light-Chain Amyloidosis
Key points
Background
Therapies directed at plasma cell or B-cell clone
Therapies directed at amyloid aggregates
Combining monoclonal antibodies
Summary
Solid Organ Transplantation
Key points
Introduction
Challenges
Opportunities
Cardiac transplantation
Renal transplantation
Liver transplantation
Discussion
Summary
Clinics Care Points
Supportive Care for Patients with Systemic Light Chain Amyloidosis
Key points
Introduction
Cardiac amyloidosis
Renal amyloidosis
Amyloidosis of the nervous system
Gastrointestinal amyloidosis
Amyloidosis and the coagulation system
Soft tissue amyloidosis
Psychosocial support
Clinics care points
The Impact of AL Amyloidosis: The Patient Experience
Key points
Introduction
Journey to diagnosis
Patient-Focused Drug Development
Meeting overview
Most significant symptoms of AL amyloidosis
Symptoms of disease versus side effects of treatment
Burden of disease and impact on daily life
Financial concerns
Psychological impact
Summary
Future Perspectives
Key points
Disease pathogenesis
Early recognition of light chain amyloidosis
Tools for better trial design
Novel therapies for light chain amyloidosis