Systemic Amyloidosis due to Monoclonal Immunoglobulins: Cardiac Involvement

Hematol Oncol Clin North Am. 2020 Dec;34(6):1055-1068. doi: 10.1016/j.hoc.2020.07.006. Epub 2020 Sep 14.

Abstract

Amyloid light chain amyloidosis (AL) is the most commonly diagnosed systemic form of amyloidosis, resulting from deposition of amyloid fibrils into various organs, such as the heart. Over the past several decades, significant advances in diagnosis and treatment have reduced overall mortality. Short-term survival, however, has not improved, in large part due to cardiovascular mortality from advanced AL cardiac amyloidosis. Early clinical suspicion of cardiac involvement is critical in order to initiate appropriate treatment and referrals for successful management. This review discusses the current challenges in diagnosis as well as available treatment options for different stages of cardiac involvement.

Keywords: AL amyloidosis; Cardiac disease; Diagnosis; Light chains.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antibodies, Monoclonal / metabolism*
  • Heart Diseases* / etiology
  • Heart Diseases* / metabolism
  • Heart Diseases* / mortality
  • Humans
  • Immunoglobulin Light Chains / metabolism*
  • Immunoglobulin Light-chain Amyloidosis* / complications
  • Immunoglobulin Light-chain Amyloidosis* / metabolism
  • Immunoglobulin Light-chain Amyloidosis* / mortality

Substances

  • Antibodies, Monoclonal
  • Immunoglobulin Light Chains