Treating Light Chain Multiple Myeloma
- Chemotherapy Drugs. For people with renal impairment, a chemotherapy drug called Velcade (bortezomib) is usually prescribed as the first line of treatment.
- High-Cutoff Hemodialysis. A type of kidney dialysis called high-cutoff hemodialysis (HCO-HD) is a newer treatment option for light chain multiple myeloma.
- Plasmapheresis. ...
What are the treatment options for light chain disease (LCD)?
Aug 02, 2016 · The goal of treating LCDD is to slow the production of light chains and their damage to organs. Treatment may include chemotherapy with a drug called Bortezomib; autologous stem cell transplantation; immunomodulatory drugs; and/or kidney transplant. If untreated, end-stage renal disease occurs in 70% of cases.
What is the treatment for light-chain deposition disease?
Treatment algorithm for light-chain (AL) amyloidosis. CHF, congestive heart failure; COM, continuous low-dosage oral melphalan; CR, complete hematologic response; Cr, creatinine; Dex, dexamethasone; HDM/SCT, high-dosage melphalan and stem cell transplantation; IV, intravenous; LVEF, left ventricular ejection fraction; Mel, melphalan; VTE, venous thromboembolic disease.
What are the treatment options for light-induced thrombocytopenia?
Treatment of idiopathic light chain deposition disease: complete remission with bortezomib and dexamethasone Abstract Light chain deposition disease (LCDD) is a rare clinical entity characterized by the deposition of light chain immunoglobulins in different tissues and primarily affects the kidneys, followed by the liver and heart.
What is the best treatment for light chain multiple myeloma?
How do I treat myeloma light chain?
How is light chain multiple myeloma treated?chemotherapy.targeted therapy.autologous stem cell transplant.steroids.bone-modifying drugs.surgery.radiation therapy.supportive therapies such as blood transfusions and antibiotics.Feb 9, 2022
How long can you live with light chain disease?
Median survival for patients with light-chain deposition disease (LCDD) is about 4 years. The largest series published so far has reported after a median follow-up of 27 months; 57% of patients developed uremia and 59% of patients died.Oct 26, 2021
What are the symptoms of light chain disease?
The symptoms a person has vary based on the reason for the light chain production. Symptoms can be related to the disease as it affects your body as a whole, such as weakness and fatigue, weight loss, bone pain, or numbness/tingling of your arms or legs.
What causes light chain?
Light chains are pieces of antibodies made by white blood cells, specifically plasma cells, in the bone marrow. In AL amyloidosis, a group of plasma cells make too many light chains, which misfold and bind together to form amyloid fibrils. The fibrils are then deposited in organs.Jun 2, 2020
Which is worse kappa or lambda myeloma?
Patients with lambda light chain disease have a three times worse prognosis than kappa light chain disease.
How common is light chain disease?
Frequency. The frequency of light-chain deposition disease (LCDD) is unknown. The disease is found in approximately 5% of patients with multiple myeloma at autopsy.Oct 26, 2021
Can light chain disease be cured?
The goal of treating LCDD is to slow the production of light chains and their damage to organs. Treatment may include chemotherapy with a drug called Bortezomib; autologous stem cell transplantation; immunomodulatory drugs; and/or kidney transplant. If untreated, end-stage renal disease occurs in 70% of cases.Aug 2, 2016
What is the life expectancy of a person with amyloidosis?
On average, people with familial ATTR amyloidosis live for 7 to 12 years after they get their diagnosis, according to the Genetic and Rare Diseases Information Center. A study published in the journal Circulation found that people with wild-type ATTR amyloidosis live an average of about 4 years after diagnosis.Apr 20, 2020
What is the best treatment for amyloidosis?
Recent studies have shown that people with newly diagnosed AL amyloidosis, the four-drug combination of subcutaneous daratumumab, bortezomib, cyclophosphamide, and dexamethasone is safe and effective. This treatment is now considered standard of care for most patients.
What is the latest treatment for amyloidosis?
Diagnoses are often delayed, and approximately 30% of patients die within the first year of diagnosis. The new approval is for subcutaneous daratumumab (Darzalex Faspro), to be used in combination with bortezomib, cyclophosphamide, and dexamethasone.Jan 20, 2021
Is light chain deposition disease hereditary?
In the usual type of immunoglobulin light-chain amyloidosis (AL), no hereditary pattern has been identified, and the disease is considered “sporadic.” The only definite requirement for amyloid formation appears to be a plasma cell dyscrasia that produces excess monoclonal amyloid fibril precursor protein.
What organs affect amyloidosis?
Amyloid isn't normally found in the body, but it can be formed from several different types of protein. Organs that may be affected include the heart, kidneys, liver, spleen, nervous system and digestive tract.Mar 14, 2020
How do you know if you have light chain disease?
The symptoms a person has vary based on the reason for the light chain production. Symptoms can be related to the disease as it affects your body as a whole, such as weakness and fatigue, weight loss, bone pain, or numbness/tingling of your arms or legs. Deposition of light chains in the heart muscle is seen in about 80% ...
Where are the chains found in light deposition disease?
In light deposition disease, the chains do not form a pattern and can be found in various sections of the kidney. The pathologist will use a special stain on the microscope to be able to see these differences.
How to tell if a biopsy is light chain deposition?
The pathologist viewing the biopsy can tell it is light chain deposition disease because it has a different appearance from other deposition diseases. In other deposition diseases, the chains will appear to form a pattern and are found in one particular section of the kidney. In light deposition disease, the chains do not form a pattern ...
How long does light chain deposition last?
Patient survival from the time that symptoms begin has ranged from 1 month to 10 years.
What is the deposition of light chains in the heart muscle?
Deposition of light chains in the heart muscle is seen in about 80% of patients with this disease , and symptoms related to the heart muscle damage can be more prominent than symptoms from the kidney.
What happens when you have light chain deposition?
Patients with light chain deposition disease make far too many light chains, which get deposited in lots of different tissues in the body, including the kidney. Some patients with light chain deposition disease will make so many that they overwhelm the kidneys’ ability to recycle or get rid of them all, and some of those proteins get stuck in ...
What age is light chain deposition most common?
Light chain deposition usually occurs along with another disease affecting the whole body. The risk of developing light chain deposition varies significantly depending on the other disease that the patient has. Patients with this disease typically are over the age of 50 and have an average age of 67. The disease is more common in men than in women.
Causes
Diagnosis
- Light chains can be seen in the kidney biopsy tissue using an electron microscope. The pathologist viewing the biopsy can tell it is light chain deposition disease because it has a different appearance from other deposition diseases. In other deposition diseases, the chains will appear to form a pattern and are found in one particular section of the kidney. In light depositio…
Epidemiology
- Light chain deposition usually occurs along with another disease affecting the whole body. The risk of developing light chain deposition varies significantly depending on the other disease that the patient has. Patients with this disease typically are over the age of 50 and have an average age of 67. The disease is more common in men than in women.
Symptoms
- The symptoms a person has vary based on the reason for the light chain production. Symptoms can be related to the disease as it affects your body as a whole, such as weakness and fatigue, weight loss, bone pain, or numbness/tingling of your arms or legs. Deposition of light chains in the heart muscle is seen in about 80% of patients with this disease, and symptoms related to the he…
Treatment
- Therapy usually is focused on treating the underlying disease, and can vary. There are some things we can do to help reduce further damage done to the kidney by the light chain deposition. These include decreasing the amount of calcium in your urine, which is done by staying well hydrated, and reducing the amount of acid in the urine. Sometimes patients will take a diuretic, …
Prognosis
- The outcome of patients with light chain deposition disease remains uncertain. In large part this is related to the effects of light chains in other organs and not necessarily due to kidney disease. Patient survival from the time that symptoms begin has ranged from 1 month to 10 years. Although the prognosis for long term kidney health is poor, there are some studies which have s…