Treatment for Amyloidosis
Treatment for amyloidosis focuses on stopping the production of amyloid proteins, managing symptoms, and protecting affected organs. The approach varies depending on the type of amyloidosis and how far the disease has progressed.
AL (Primary) Amyloidosis Treatment
- Chemotherapy
- Similar to treatments used for multiple myeloma
- Common drugs include bortezomib, cyclophosphamide, and dexamethasone
- Aims to kill abnormal plasma cells producing amyloid proteins
- Autologous Stem Cell Transplant
- In select patients, stem cells are harvested and reintroduced after high-dose chemotherapy
- Only suitable for patients with good overall health
AA (Secondary) Amyloidosis Treatment
- Focus is on treating the underlying inflammatory condition
- Doctors must aggressively manage TB, arthritis, or IBD
- Doctors use anti-inflammatory medications and sometimes biologic agents
- If successful, amyloid production slows or stops
Hereditary
- TTR-stabilising medications (e.g. tafamidis) can reduce amyloid formation
- In severe cases, doctors may consider a liver transplant to replace the source of mutant TTR protein
Dialysis-Related
- Improve dialysis techniques (e.g. using high-flux filters)
- Consider kidney transplant, which can reverse the condition in some patients
Supportive Care
Regardless of type, supportive treatment is critical:
- Heart medications for heart failure
- Diuretics to manage fluid retention
- Dialysis for kidney failure
- Pain relief and physiotherapy for nerve and joint issues
Lifestyle Adjustments
- Salt and fluid restriction (in cases of heart or kidney involvement)
- Managing infections promptly
- Psychological support for depression, fear, and fatigue
With early treatment, doctors can stabilize or even improve symptoms. However, in late stages, the condition may be harder to control. Understanding the risks is vital.
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