Amyloidosis treatment: drugs, chemotherapy to transplantation

No one specific drug is yet known to treat amyloidosis.

Since there are several types of amyloidosis that have different causes, even the treatment for this condition will be varied.

The therapy for the disease itself is to reduce the symptoms and alleviate the symptoms of the disease by preventing further production of amyloid protein and thus organ damage.

Chemotherapy

AL amyloidosis is treated with the same or similar drugs as some cancers. The aim of therapy is to stop the growth of abnormal cells and eliminate the clone of plasma cells that produce the protein that leads to amyloid formation.

The treatment therefore results in a total remission of the disease. If the production and storage of amyloid stops, the body can even get rid of the excess amyloid accumulated in the organs completely.

In this way, organs that are not yet permanently damaged can be saved.

Transplantation

Chemotherapy is often combined with an autologous hematopoietic cell transplant to enhance the effect of the therapy.

This procedure involves collecting the patient's own stem cells from the blood through a vein and storing them for a short time. During this period, the patient takes high doses of chemotherapy

The stem cells are then returned to the patient's body through a vein.

The transplant is only suitable for patients who do not already have severe organ damage, especially to the heart.

Supportive therapy

Supportive therapy is an important part of proper therapy. It relieves symptoms resulting from organ damage.

When the kidneys are damaged and the nephrotic syndrome (urination of large amounts of protein) develops, salt and fluid restriction, diuretics, albumin replacement and, in the case of remission of amyloidosis, kidney transplantation are recommended.

In patients who are not suitable candidates for kidney transplantation, dialysis is an option.

Dialysis uses a machine that periodically filters out all metabolic waste, salts and fluids from the blood.

In this way, it replaces the function of the kidneys.

In the event of heart damage and subsequent heart failure, treatment with diuretics and aldosterone antagonists is introduced.

Severe cardiac rhythm disturbances (arrhythmias) are treated by administering, for example, amiodarone. Digoxin is inappropriate in this case. If the cardiac rhythm is not corrected, surgical pacemaker transplantation is indicated.

In patients with severe but isolated cardiac damage, consideration of heart transplantation is appropriate.

Some types of amyloid form in the liver, so liver transplantation can stop this production.