title: Treatment of Immunoglobulin Light Chain Amyloidosis: Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Statement.
abstract: Immunoglobulin light chain amyloidosis (AL amyloidosis) has an incidence of approximately 1 case per 100,000 person-years in Western countries. The rarity of the condition not only poses a challenge for making a prompt diagnosis but also makes evidenced decision making about treatment even more challenging. Physicians caring for patients with AL amyloidosis have been borrowing and customizing the therapies used for patients with multiple myeloma with varying degrees of success. One of the biggest failings in the science of the treatment of AL amyloidosis is the paucity of prospective trials, especially phase 3 trials. Herein, we present an extensive review of the literature with an aim of making recommendations in the context of the best evidence and expert opinion.
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN. Electronic address: dispenzieri.angela@mayo.edu.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Shaji K
authors.initials: SK
authors.lastname: Kumar
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
authors.forename: Craig B
authors.initials: CB
authors.lastname: Reeder
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL.
authors.forename: Tamur
authors.initials: T
authors.lastname: Sher
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Mikhael
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL.
authors.forename: Vivek
authors.initials: V
authors.lastname: Roy
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Martha
authors.initials: M
authors.lastname: Grogan
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kapoor
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: John A
authors.initials: JA
authors.lastname: Lust
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Go
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Yi Lisa
authors.initials: YL
authors.lastname: Hwa
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hayman
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL.
authors.forename: Sikander
authors.initials: S
authors.lastname: Ailawadhi
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
authors.forename: P Leif
authors.initials: PL
authors.lastname: Bergsagel
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL.
authors.forename: Ascher
authors.initials: A
authors.lastname: Chanan-Khan
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Russell
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
authors.forename: Keith
authors.initials: K
authors.lastname: Stewart
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Zeldenrust
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN.
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
mesh_terms: D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D032921:Consensus; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000502:physiology*; D009101:Multiple Myeloma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
chemical_list: D007147:Immunoglobulin Light Chains