News in the treatment of AL amyloidosis

Systemic AL amyloidosis is a severe illness. Its prognosis depends on the extent of amyloid deposits and the importance of cardiac involvement. Without effective treatment the median survival is about 12 months [1], but the notion that the formation of amyloid deposits is an irreversible process is false. There is a balance between formation and removal of deposits, that varies considerably among patients and according to the organs. The removal or reduction of the monoclonal light chain serum concentration of the origin of deposits may tip the balance and be accompanied by a progressive elimination of deposits. The degree of reduction in the production of monoclonal light chains necessary for tissue removal, varies between patients and depends on the turnover of amyloid deposits. If the treatment is effective, clinical improvement can sometimes be rapid and dramatic, or more often occur after many months.