1. Treatment of Immunoglobulin Light Chain Amyloidosis
Angela Dispenzieri, MD, Francis Buadi, MD, Shaji K. Kumar, MD, Craig B. Reeder, MD, Tamur Sher, MD, Martha Q. Lacy, MD, Robert A. Kyle, MD, Joseph R. Mikhael, MD, Vivek Roy, MD, Nelson Leung, MD, Martha Grogan, MD, Prashant Kapoor, MD, John A. Lust, MD, PhD, David Dingli, MD, Ronald S. Go, MD, Yi Lisa Hwa, PhD, Suzanne R. Hayman, MD, Rafael Fonseca, MD, Sikander Ailawadhi, MD, P. Leif Bergsagel, MD, Ascher Chanan-Khan, MD, S. Vincent Rajkumar, MD, Stephen J. Russell, MD, PhD, Keith Stewart, MD, Steven R. Zeldenrust, MD, PhD, Morie A. Gertz, MD, MACP 
Mayo Clinic Proceedings 
Volume 90, Issue 8, Pages (August 2015)
DOI: /j.mayocp
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2. Figure 1
Nonstudy treatment algorithm for patients with newly diagnosed immunoglobulin light chain amyloidosis (AL amyloidosis). Note that many of the recommendations in this algorithm have not yet been supported by clinical trials; level of evidence is clearly indicated in the text. aTo be transplant eligible, the following criteria should be met: physiologic age 70 years or younger; performance score of 2 or less; troponin T level less than 0.06 ng/mL, systolic blood pressure of at least 90 mm Hg; creatinine clearance of at least 30 mL/min (unless undergoing long-term dialysis), New York Heart Association class I/II, and no more than 2 major organs significantly involved (liver, heart, kidney, or autonomic nerve). bInduction also used if there is a delay in proceeding to autologous stem cell transplant or as clinically indicated. cIf the hematologic parameter is not decreased by more than 50% at 2 months, consider changing therapy. dFor age older than 70 years or creatinine clearance less than 30 mL/min/1.73 m2, use melphalan 140 mg/m2. eMayo 2012 stage I or II. fDay 100 autologous stem cell transplant or after 4 to 6 cycles of chemotherapy. BM = bone marrow; CRAB = hypercalcemia, renal insufficiency, anemia, or bone disease; CyBorD = cyclophosphamide, bortezomib, and dexamethasone; Dex = dexamethasone; dFLC = difference between involved and uninvolved serum immunoglobulin free light chain levels; HSCT = hematopoietic stem cell transplant; Mel = melphalan; PC = plasma cells; PR = partial response; VGPR = very good partial response.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
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3. Figure 2
Nonstudy treatment algorithm for transplant-eligible patients with relapsed or refractory immunoglobulin light chain amyloidosis (AL amyloidosis). Note that many of the recommendations in this algorithm have not yet been supported by clinical trials; level of evidence is clearly indicated in the text. CyBorD = cyclophosphamide, bortezomib, and dexamethasone; Dex = dexamethasone; Len = lenalidomide; Mel = melphalan; POM = pomalidomide; Vd = velcade and dexamethasone.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions