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Light-chain amyloidosis: SCT, novel agents and beyond

Bone Marrow Transplantation volume 48, pages 1022–1027 (2013)Cite this article

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Abstract

Light-chain amyloidosis is a plasma cell dyscrasia characterized by the production of fibrillar proteins comprised of monoclonal light chains, which deposit in tissues causing multiorgan dysfunction and death. The diagnosis is challenging and requires a biopsy and often specialized testing to confirm the subtype of systemic disease. The goal of treatment is eradication of the monoclonal plasma cell population and suppression of the pathologic light chains, which improve organ function and extend survival. Standard treatment approaches have included high-dose melphalan followed by autologous hematopoietic SCT or oral melphalan with dexamethasone. The use of novel agents (thalidomide, lenalidomide and bortezomib) alone and in combination with steroids and alkylating agents has shown efficacy and continues to be explored. A risk-adapted approach to SCT followed by novel agents as consolidation, reduces treatment-related mortality with promising activity. Immunotherapy targeting pathologic plasma cells and amyloid fibrils is being developed and could potentially eliminate visceral amyloid deposits. Improved understanding of the biology that renders light-chains amyloidogenic and a commitment to refer patients to specialized centers conducting well-designed clinical trials is essential to improve patient outcomes.

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References

  1. Bhat A, Selmi C, Naguwa SM, Cheema GS, Gershwin ME . Currents concepts on the immunopathology of amyloidosis. Clin Rev Allergy Immunol 2010; 38: 97–106.

    Article  PubMed  Google Scholar 

  2. Falk RH, Comenzo RL, Skinner M . The systemic amyloidoses. N Engl J Med 1997; 337: 898–909.

    Article  CAS  PubMed  Google Scholar 

  3. Kyle RA, Bayrd ED . ‘Primary’ systemic amyloidosis and myeloma. Discussion of relationship and review of 81 cases. Arch Intern Med 1961; 107: 344–353.

    Article  CAS  PubMed  Google Scholar 

  4. Kyle RA, Gertz MA . Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Semin Hematol 1995; 32: 45–59.

    CAS  PubMed  Google Scholar 

  5. Kyle RA, Linos A, Beard CM, Linke RP, Gertz MA, O'Fallon WM et al. Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989. Blood 1992; 79: 1817–1822.

    CAS  PubMed  Google Scholar 

  6. Merlini G, Seldin DC, Gertz MA . Amyloidosis: pathogenesis and new therapeutic options. J Clin Oncol 2011; 29: 1924–1933.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gertz MA, Lacy MQ, Dispenzieri A, Hayman SR, Kumar SK, Dingli D et al. Autologous stem cell transplant for immunoglobulin light chain amyloidosis: a status report. Leuk Lymphoma 2010; 51: 2181–2187.

    Article  PubMed  Google Scholar 

  8. Comenzo RL, Zhou P, Fleisher M, Clark B, Teruya-Feldstein J . Seeking confidence in the diagnosis of systemic AL (Ig light-chain) amyloidosis: patients can have both monoclonal gammopathies and hereditary amyloid proteins. Blood 2006; 107: 3489–3491.

    Article  CAS  PubMed  Google Scholar 

  9. Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen HR, Dogan A . Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood 2009; 114: 4957–4959.

    Article  CAS  PubMed  Google Scholar 

  10. Arbustini E, Verga L, Concardi M, Palladini G, Obici L, Merlini G . Electron and immuno-electron microscopy of abdominal fat identifies and characterizes amyloid fibrils in suspected cardiac amyloidosis. Amyloid 2002; 9: 108–114.

    Article  CAS  PubMed  Google Scholar 

  11. Lachmann HJ, Booth DR, Booth SE, Bybee A, Gilbertson JA, Gillmore JD et al. Misdiagnosis of hereditary amyloidosis as AL (primary) amyloidosis. N Engl J Med 2002; 346: 1786–1791.

    Article  CAS  PubMed  Google Scholar 

  12. Comenzo RL . How I treat amyloidosis. Blood 2009; 114: 3147–3157.

    Article  CAS  PubMed  Google Scholar 

  13. Seldin DC, Choufani EB, Dember LM, Wiesman JF, Berk JL, Falk RH et al. Tolerability and efficacy of thalidomide for the treatment of patients with light chain-associated (AL) amyloidosis. Clin Lymphoma 2003; 3: 241–246.

    Article  CAS  PubMed  Google Scholar 

  14. Sanchorawala V, Finn KT, Fennessey S, Shelton A, Doros G, Zeldis JB et al. Durable hematologic complete responses can be achieved with lenalidomide in AL amyloidosis. Blood 2010; 116: 1990–1991.

    Article  CAS  PubMed  Google Scholar 

  15. Reece DE, Sanchorawala V, Hegenbart U, Merlini G, Palladini G, Fermand JP et al. Weekly and twice-weekly bortezomib in patients with systemic AL amyloidosis: results of a phase 1 dose-escalation study. Blood 2009; 114: 1489–1497.

    Article  CAS  PubMed  Google Scholar 

  16. Reece DE, Hegenbart U, Sanchorawala V, Merlini G, Palladini G, Blade J et al. Efficacy and safety of once-weekly and twice-weekly bortezomib in patients with relapsed systemic AL amyloidosis: results of a phase 1/2 study. Blood 2011; 118: 865–873.

    Article  CAS  PubMed  Google Scholar 

  17. Gertz MA . Immunoglobulin light chain amyloidosis: 2011 update on diagnosis, risk-stratification, and management. Am J Hematol 2011; 86: 180–186.

    Article  PubMed  Google Scholar 

  18. Dispenzieri A, Gertz MA, Kyle RA, Lacy MQ, Burritt MF, Therneau TM et al. Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. J Clin Oncol 2004; 22: 3751–3757.

    Article  CAS  PubMed  Google Scholar 

  19. Kumar S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Colby C et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. J Clin Oncol 2012; 30: 989–995.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Wechalekar AD, Gillmore JD, Wassef N, Lachmann HJ, Whelan C, Hawkins PN . Abnormal N-terminal fragment of brain natriuretic peptide in patients with light chain amyloidosis without cardiac involvement at presentation is a risk factor for development of cardiac amyloidosis. Haematologica 2011; 96: 1079–1080.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Girnius S, Seldin DC, Quillen K, Andrea NT, Sloan JM, Berk JL et al. High-dose melphalan and stem cell transplantation for patients with al amyloidosis and cardiac involvement. ASH Annual Meeting Abstracts 2011; 118: 2043.

    Google Scholar 

  22. Wechalekar A, Schonland SO, Kastritis E, Hawkins PN, Dimopoulos MA, Russo P et al. European Collaborative Study of Treatment Outcomes in 347 patients with systemic AL amyloidosis with mayo stage III disease. ASH Annual Meeting Abstracts 2011; 118: 995.

    Google Scholar 

  23. Gertz MA, Lacy MQ, Dispenzieri A, Hayman SR, Kumar SK, Leung N et al. Effect of hematologic response on outcome of patients undergoing transplantation for primary amyloidosis: importance of achieving a complete response. Haematologica 2007; 92: 1415–1418.

    Article  PubMed  Google Scholar 

  24. Skinner M, Sanchorawala V, Seldin DC, Dember LM, Falk RH, Berk JL et al. High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study. Ann Intern Med 2004; 140: 85–93.

    Article  CAS  PubMed  Google Scholar 

  25. Gertz MA, Lacy MQ, Dispenzieri A, Hayman SR, Kumar S . Transplantation for amyloidosis. Curr Opin Oncol 2007; 19: 136–141.

    Article  CAS  PubMed  Google Scholar 

  26. Gertz MA, Comenzo R, Falk RH, Fermand JP, Hazenberg BP, Hawkins PN et al. Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, 18-22 April 2004. Am J Hematol 2005; 79: 319–328.

    Article  PubMed  Google Scholar 

  27. Palladini G, Dispenzieri A, Gertz MAA, Wechalekar A, Hawkins PN, Schonland SO et al. Validation of the criteria of response to treatment in al amyloidosis. Blood 2010; 116: 586–587.

    Article  Google Scholar 

  28. Comenzo RL, Reece D, Palladini G, Seldin D, Sanchorawala V, Landau H et al. Consensus guidelines for the conduct and reporting of clinical trials in systemic light-chain (AL) amyloidosis. Leukemia 2012.

  29. Kyle RA, Gertz MA, Greipp PR, Witzig TE, Lust JA, Lacy MQ et al. A trial of three regimens for primary amyloidosis: colchicine alone, melphalan and prednisone, and melphalan, prednisone, and colchicine. N Engl J Med 1997; 336: 1202–1207.

    Article  CAS  PubMed  Google Scholar 

  30. Comenzo RL, Vosburgh E, Simms RW, Bergethon P, Sarnacki D, Finn K et al. Dose-intensive melphalan with blood stem cell support for the treatment of AL amyloidosis: one-year follow-up in five patients. Blood 1996; 88: 2801–2806.

    CAS  PubMed  Google Scholar 

  31. Comenzo RL, Vosburgh E, Falk RH, Sanchorawala V, Reisinger J, Dubrey S et al. Dose-intensive melphalan with blood stem-cell support for the treatment of AL (amyloid light-chain) amyloidosis: survival and responses in 25 patients. Blood 1998; 91: 3662–3670.

    CAS  PubMed  Google Scholar 

  32. Gertz MA, Lacy MQ, Gastineau DA, Inwards DJ, Chen MG, Tefferi A et al. Blood stem cell transplantation as therapy for primary systemic amyloidosis (AL). Bone Marrow Transplant 2000; 26: 963–969.

    Article  CAS  PubMed  Google Scholar 

  33. Comenzo RL, Sanchorawala V, Fisher C, Akpek G, Farhat M, Cerda S et al. Intermediate-dose intravenous melphalan and blood stem cells mobilized with sequential GM+G-CSF or G-CSF alone to treat AL (amyloid light chain) amyloidosis. Br J Haematol 1999; 104: 553–559.

    Article  CAS  PubMed  Google Scholar 

  34. Saba N, Sutton D, Ross H, Siu S, Crump R, Keating A et al. High treatment-related mortality in cardiac amyloid patients undergoing autologous stem cell transplant. Bone Marrow Transplant 1999; 24: 853–855.

    Article  CAS  PubMed  Google Scholar 

  35. Gillmore JDAJ, Craddock C et al High Dose Melphalan and Stem Cell Rescue for Al Amyloidosis. Parthenon Publishing Pearl River: NY, 1999.

    Google Scholar 

  36. Moreau P, Leblond V, Bourquelot P, Facon T, Huynh A, Caillot D et al. Prognostic factors for survival and response after high-dose therapy and autologous stem cell transplantation in systemic AL amyloidosis: a report on 21 patients. Br J Haematol 1998; 101: 766–769.

    Article  CAS  PubMed  Google Scholar 

  37. Comenzo RL, Gertz MA . Autologous stem cell transplantation for primary systemic amyloidosis. Blood 2002; 99: 4276–4282.

    Article  CAS  PubMed  Google Scholar 

  38. Syme R, Bewick M, Stewart D, Porter K, Chadderton T, Gluck S . The role of depletion of dimethyl sulfoxide before autografting: on hematologic recovery, side effects, and toxicity. Biol Blood Marrow Transplant 2004; 10: 135–141.

    Article  CAS  PubMed  Google Scholar 

  39. Fois E, Desmartin M, Benhamida S, Xavier F, Vanneaux V, Rea D et al. Recovery, viability and clinical toxicity of thawed and washed haematopoietic progenitor cells: analysis of 952 autologous peripheral blood stem cell transplantations. Bone Marrow Transplant 2007; 40: 831–835.

    Article  CAS  PubMed  Google Scholar 

  40. Goldsmith YB, Liu J, Chou J, Hoffman J, Comenzo RL, Steingart RM . Frequencies and types of arrhythmias in patients with systemic light-chain amyloidosis with cardiac involvement undergoing stem cell transplantation on telemetry monitoring. Am J Cardiol 2009; 104: 990–994.

    Article  PubMed  Google Scholar 

  41. Kumar S, Dispenzieri A, Gertz MA . High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. N Engl J Med 2008; 358: 91–93.

    Article  CAS  PubMed  Google Scholar 

  42. Gertz M, Lacy M, Dispenzieri A, Hayman S, Kumar S, Buadi F et al. Troponin T level as an exclusion criterion for stem cell transplantation in light-chain amyloidosis. Leuk Lymphoma 2008; 49: 36–41.

    Article  CAS  PubMed  Google Scholar 

  43. Refinement in Patient Selection Can Reduce the Treatment-Related Mortality from Stem Cell Transplantation in Amyloidosis to <2%. XIII International Symposium on Amyloidosis. Groningen: The Netherlands, 2012.

  44. Cohen AD, Zhou P, Chou J, Teruya-Feldstein J, Reich L, Hassoun H et al. Risk-adapted autologous stem cell transplantation with adjuvant dexamethasone ± thalidomide for systemic light-chain amyloidosis: results of a phase II trial. Br J Haematol 2007; 139: 224–233.

    Article  CAS  PubMed  Google Scholar 

  45. Cibeira MT, Sanchorawala V, Seldin DC, Quillen K, Berk JL, Dember LM et al. Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation: long-term results in a series of 421 patients. Blood 2011; 118: 4346–4352.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Oran B, Malek K, Sanchorawala V, Wright DG, Quillen K, Finn KT et al. Predictive factors for hematopoietic engraftment after autologous peripheral blood stem cell transplantation for AL amyloidosis. Bone Marrow Transplant 2005; 35: 567–575.

    Article  CAS  PubMed  Google Scholar 

  47. Gertz MA, Lacy MQ, Dispenzieri A, Ansell SM, Elliott MA, Gastineau DA et al. Risk-adjusted manipulation of melphalan dose before stem cell transplantation in patients with amyloidosis is associated with a lower response rate. Bone Marrow Transplant 2004; 34: 1025–1031.

    Article  CAS  PubMed  Google Scholar 

  48. Landau H, Hassoun H, Bello C, Hoover E, Riedel ER, Nimer SD et al. Consolidation with bortezomib and dexamethasone following risk-adapted melphalan and stem cell transplant in systemic AL amyloidosis. Amyloid-J Protein Folding Disord 2011; 18: 135–136.

    Article  Google Scholar 

  49. Landau H, Hassoun H, Rosenzweig MA, Maurer M, Liu J, Flombaum C et al. Bortezomib and dexamethasone consolidation following risk-adapted melphalan and stem cell transplantation for patients with newly diagnosed light chain amyloidosis. Leukemia 2013; 27: 823–828.

    Article  CAS  PubMed  Google Scholar 

  50. Jaccard A, Moreau P, Leblond V, Leleu X, Benboubker L, Hermine O et al. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. N Engl J Med 2007; 357: 1083–1093.

    Article  CAS  PubMed  Google Scholar 

  51. Jaccard A, Leblond V, Royer B, Leleu X, Delarue R, Kolb B et al. Autologous stem cell transplantation (asct) versus oral melphalan and high-dose dexamethasone in patients with al (primary) amyloidosis: long term follow-up of the French Multicentric Randomized Trial. ASH Annual Meeting Abstracts 2010; 116: 1344.

    Google Scholar 

  52. Gillmore JD, Davies J, Iqbal A, Madhoo S, Russell NH, Hawkins PN . Allogeneic bone marrow transplantation for systemic AL amyloidosis. Br J Haematol 1998; 100: 226–228.

    Article  CAS  PubMed  Google Scholar 

  53. Kawai Y, Kinoshita K, Arai H, Kuwata A . Fukuoka Y, Yamaoka M et al. Reduced intensity allogeneic stem cell transplantation for systemic primary amyloidosis refractory to high-dose melphalan. Eur J Haematol 2004; 72: 448–450.

    Article  PubMed  Google Scholar 

  54. Guillaume B, Straetmans N, Jadoul M, Cosyns JP, Ferrant A . Allogeneic bone marrow transplantation for AL amyloidosis. Bone Marrow Transplant 1997; 20: 907–908.

    Article  CAS  PubMed  Google Scholar 

  55. Imamura T, Ogata M, Kohno K, Tomo T, Ohtsuka E, Kikuchi H et al. Successful reduced intensity allogeneic stem cell transplantation for systemic AL amyloidosis. Am J Hematol 2006; 81: 281–283.

    Article  PubMed  Google Scholar 

  56. Schonland SO, Lokhorst H, Buzyn A, Leblond V, Hegenbart U, Bandini G et al. Allogeneic and syngeneic hematopoietic cell transplantation in patients with amyloid light-chain amyloidosis: a report from the European Group for Blood and Marrow Transplantation. Blood 2006; 107: 2578–2584.

    Article  PubMed  Google Scholar 

  57. Sanchorawala V, Wright DG, Seldin DC, Falk RH, Berk JL, Dember LM et al. Low-dose continuous oral melphalan for the treatment of primary systemic (AL) amyloidosis. Br J Haematol 2002; 117: 886–889.

    Article  CAS  PubMed  Google Scholar 

  58. Dhodapkar MV, Hussein MA, Rasmussen E, Solomon A, Larson RA, Crowley JJ et al. Clinical efficacy of high-dose dexamethasone with maintenance dexamethasone/alpha interferon in patients with primary systemic amyloidosis: results of United States Intergroup Trial Southwest Oncology Group (SWOG) S9628. Blood 2004; 104: 3520–3526.

    Article  CAS  PubMed  Google Scholar 

  59. Palladini G, Perfetti V, Obici L, Caccialanza R, Semino A, Adami F et al. Association of melphalan and high-dose dexamethasone is effective and well tolerated in patients with AL (primary) amyloidosis who are ineligible for stem cell transplantation. Blood 2004; 103: 2936–2938.

    Article  CAS  PubMed  Google Scholar 

  60. Palladini G, Russo P, Nuvolone M, Lavatelli F, Perfetti V, Obici L et al. Treatment with oral melphalan plus dexamethasone produces long-term remissions in AL amyloidosis. Blood 2007; 110: 787–788.

    Article  CAS  PubMed  Google Scholar 

  61. Dispenzieri A, Lacy MQ, Rajkumar SV, Geyer SM, Witzig TE, Fonseca R et al. Poor tolerance to high doses of thalidomide in patients with primary systemic amyloidosis. Amyloid 2003; 10: 257–261.

    Article  CAS  PubMed  Google Scholar 

  62. Sanchorawala V, Wright DG, Rosenzweig M, Finn KT, Fennessey S, Zeldis JB et al. Lenalidomide and dexamethasone in the treatment of AL amyloidosis: results of a phase 2 trial. Blood 2007; 109: 492–496.

    Article  CAS  PubMed  Google Scholar 

  63. Hegenbart U, Bochtler T, Dietrich S, Ho AD, Schonland S . Treatment of light chain amyloidosis patients with lenalidomide and dexamethasone after failure of melphalan-containing chemotherapies. Amyloid-J Protein Folding Disord 2010; 17: 186–187.

    Google Scholar 

  64. Menon SP, Rajkumar SV, Lacy M, Falco P, Palumbo A . Thromboembolic events with lenalidomide-based therapy for multiple myeloma. Cancer 2008; 112: 1522–1528.

    Article  CAS  PubMed  Google Scholar 

  65. Batts ED, Sanchorawala V, Hegerfeldt Y, Lazarus HM . Azotemia associated with use of lenalidomide in plasma cell dyscrasias. Leuk Lymphoma 2008; 49: 1108–1115.

    Article  CAS  PubMed  Google Scholar 

  66. Moreau P, Jaccard A, Benboubker L, Royer B, Leleu X, Bridoux F et al. Lenalidomide in combination with melphalan and dexamethasone in patients with newly diagnosed AL amyloidosis: a multicenter phase 1/2 dose-escalation study. Blood 2010; 116: 4777–4782.

    Article  CAS  PubMed  Google Scholar 

  67. Kumar SK, Hayman SR, Buadi FK, Roy V, Lacy MQ, Gertz MA et al. Lenalidomide, cyclophosphamide, and dexamethasone (CRd) for light-chain amyloidosis: long-term results from a phase 2 trial. Blood 2012; 119: 4860–4867.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Dispenzieri A, Gertz MA, Hayman SR, Buadi F, Kumar SK, Reeder C et al. Pomalidomide and dexamethasone for previously treated AL: a phase 2 study. Amyloid-J Protein Folding Disord 2010; 17: 87–87.

    Google Scholar 

  69. Dispenzieri A, Dingli D, Kumar SK, Rajkumar SV, Lacy MQ, Hayman S et al. Discordance between serum cardiac biomarker and immunoglobulin-free light-chain response in patients with immunoglobulin light-chain amyloidosis treated with immune modulatory drugs. Am J Hematol 2010; 85: 757–759.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Kastritis E, Wechalekar AD, Dimopoulos MA, Merlini G, Hawkins PN, Perfetti V et al. Bortezomib with or without dexamethasone in primary systemic (light chain) amyloidosis. J Clin Oncol 2010; 28: 1031–1037.

    Article  CAS  PubMed  Google Scholar 

  71. Zonder JA, Sanchorawala V, Snyder RM, Matous J, Terebelo H, Janakiraman N et al. Melphalan and dexamethasone plus bortezomib induces hematologic and organ responses in al-amyloidosis with tolerable neurotoxicity. Blood 2009; 114: 310–311.

    Article  Google Scholar 

  72. Zonder J, Sanchorawala V, Snyder R, Matous J, Terebelo H, Janakiraman N et al. Rapid haematologic and organ responses in patients with AL amyloid treated with bortezomib plus melphalan and dexamethasone. Amyloid-J Protein Folding Disord 2010; 17: 86–87.

    Article  Google Scholar 

  73. Mikhael JR, Schuster SR, Jimenez-Zepeda VH, Bello N, Spong J, Reeder CB et al. Cyclophosphamide-bortezomib-dexamethasone (CyBorD) produces rapid and complete hematologic response in patients with AL amyloidosis. Blood 2012; 119: 4391–4394.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Venner CP, Lane T, Foard D, Rannigan L, Gibbs SD, Pinney JH et al. Cyclophosphamide, bortezomib, and dexamethasone therapy in AL amyloidosis is associated with high clonal response rates and prolonged progression-free survival. Blood 2012; 119: 4387–4390.

    Article  CAS  PubMed  Google Scholar 

  75. Gillmore JD, Tennent GA, Hutchinson WL, Gallimore JR, Lachmann HJ, Goodman HJ et al. Sustained pharmacological depletion of serum amyloid P component in patients with systemic amyloidosis. Br J Haematol 2010; 148: 760–767.

    Article  CAS  PubMed  Google Scholar 

  76. Pepys MB, Herbert J, Hutchinson WL, Tennent GA, Lachmann HJ, Gallimore JR et al. Targeted pharmacological depletion of serum amyloid P component for treatment of human amyloidosis. Nature 2002; 417: 254–259.

    Article  CAS  PubMed  Google Scholar 

  77. Pepys MB, Rademacher TW, Amatayakul-Chantler S, Williams P, Noble GE, Hutchinson WL et al. Human serum amyloid P component is an invariant constituent of amyloid deposits and has a uniquely homogeneous glycostructure. Proc Natl Acad Sci USA 1994; 91: 5602–5606.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Bodin K, Ellmerich S, Kahan MC, Tennent GA, Loesch A, Gilbertson JA et al. Antibodies to human serum amyloid P component eliminate visceral amyloid deposits. Nature 2010; 468: 93–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Hrncic R, Wall J, Wolfenbarger DA, Murphy CL, Schell M, Weiss DT et al. Antibody-mediated resolution of light chain-associated amyloid deposits. Am J Pathol 2000; 157: 1239–1246.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Solomon A, Weiss DT, Wall JS . Immunotherapy in systemic primary (AL) amyloidosis using amyloid-reactive monoclonal antibodies. Cancer Biother Radiopharm 2003; 18: 853–860.

    Article  CAS  PubMed  Google Scholar 

  81. Jungbluth AA, Ely S, DiLiberto M, Niesvizky R, Williamson B, Frosina D et al. The cancer-testis antigens CT7 (MAGE-C1) and MAGE-A3/6 are commonly expressed in multiple myeloma and correlate with plasma-cell proliferation. Blood 2005; 106: 167–174.

    Article  CAS  PubMed  Google Scholar 

  82. Rosenzweig MA, Landau H, Seldin D, O'Hara C, Girnius S, Hanson N et al. Cancer-testis antigen expression and immunogenicity in AL amyloidosis. Blood Cancer J 2012; 2: e90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Research funds provided by a grant from Empire Clinical Research Investigator Program (ECRIP).

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  1. Department of Hematology and HCT, City of Hope National Cancer Center, Duarte, CA, USA

    M Rosenzweig

  2. Adult Bone Marrow Transplant Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    S Giralt & H Landau

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Rosenzweig, M., Giralt, S. & Landau, H. Light-chain amyloidosis: SCT, novel agents and beyond. Bone Marrow Transplant 48, 1022–1027 (2013). https://doi.org/10.1038/bmt.2012.199

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