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FNA of the abdominal fat pad shows amyloid deposits in 70-75% of cases of suspected AL amyloidosis and diagnosed 85% of cases when combined with a bone marrow biopsy. [4] Other peripheral areas such as the salivary glands, gingiva, rectum or skin may also be biopsied, however in some cases a biopsy of the target organ may be needed. [4]
In particular, bone marrow transplant restored the ability of monocytes to eliminate amyloid-beta build up, reducing cerebral and plasma amyloid-beta levels in the 9-month-old mice that had ...
Survival diminishes with increasing stage, but recent advancements in treatments have improved median survival rates for stages I, II, and III, to 91.2, 60, and 7 months respectively. [45] Outcomes in a person with AA amyloidosis depend on the underlying disease, organ(s) affected, and correlate with the concentration of serum amyloid A protein ...
[61] [42] This is due to a therapeutic immune reaction of the grafted donor T lymphocytes against the diseased bone marrow of the recipient. This lower rate of relapse accounts for the increased success rate of allogeneic transplants, compared to transplants from identical twins, and indicates that allogeneic HSCT is a form of immunotherapy.
Overall response rate of 94% (15/16) Complete response rate of 75% (12/16) (9 out of 16 were MRD- 10-5) Organ response rate of 62% (8/13 evaluable) Best responder had a duration of response of 31.5 months as of December 9, 2024, with complete response ongoing; There were no immune effector cell-associated neurotoxicity syndrome (ICANS) events
The initial change, often involving one chromosome 14 translocation, establishes a clone of bone marrow plasma cells that causes the asymptomatic disorder MGUS, which is a premalignant disorder characterized by increased numbers of plasma cells in the bone marrow or the circulation of a myeloma protein immunoglobulin.
Following chemotherapy, a bone marrow transplant can be utilized to restore the normal cell lines. [5] There are newer medications (ixazomib, carfilzomib, daratumumab, elotuzumab) under research for the treatment of multiple myeloma that can help to decrease the production of free light chains. [5]
The more aggressive forms of disease require treatment with chemotherapy, radiotherapy, immunotherapy and—in some cases—a bone marrow transplant. The use of rituximab has been established for the treatment of B-cell–derived hematologic malignancies, including follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL). [7]
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