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MINI REVIEW article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1425521
This article is part of the Research Topic Transplantation and Cellular Therapy in Lymphomas and Plasma Cell Disorders View all 10 articles

Treatment of AL Amyloidosis in the era of novel immune and cellular therapies

Provisionally accepted
Heather Landau Heather Landau 1*Caitlin Sarubbi Caitlin Sarubbi 2Hesham Abowali Hesham Abowali 3Cindy Varga Cindy Varga 4
  • 1 Memorial Sloan Kettering Cancer Center, New York, United States
  • 2 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States
  • 3 Brookdale University Hospital and Medical Center, Brooklyn, New York, United States
  • 4 Levine Cancer Institute, Atrium Health Carolinas Medical Center (CMC), North Carolina, North Carolina, United States

The final, formatted version of the article will be published soon.

    Light chain (AL) amyloidosis is a plasma cell disorder distinguished from multiple myeloma (MM) by the degree of organ involvement due to tissue deposition of misfolded proteins. Treatments for AL amyloidosis have largely been borrowed from those developed for patients with MM. High dose chemotherapy followed by autologous stem cell transplant (ASCT) has historically been associated with the best outcomes. The recent incorporation of Daratumumab into up front therapy represents a significant advance and has changed the treatment paradigm calling into question the role of ASCT. The development of very active novel immune and cellular therapies, specifically B Cell Maturation Antigen (BCMA) directed therapies, has similarly been transformative for patients with MM and are now being studied in patients with AL amyloidosis. These include chimeric antigen receptor (CAR) T cells, bispecific antibodies and antibody drug conjugates. Although limited, preliminary data in patients with relapsed and refractory AL amyloidosis are showing promising results and it is expected that the treatment landscape for AL amyloidosis will continue to evolve. Particular attention to safety, potential for organ recovery and quality of life will be important when evaluating new treatments and/or treatment paradigms.

    Keywords: AL amyloidosis, bispecific antibodies, CAR T cell therapy, Stem cell transplant, Daratumumab

    Received: 29 Apr 2024; Accepted: 15 May 2024.

    Copyright: © 2024 Landau, Sarubbi, Abowali and Varga. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Heather Landau, Memorial Sloan Kettering Cancer Center, New York, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.