title: Disease burden of systemic light-chain amyloidosis: a systematic literature review.
abstract: A systematic literature review on systemic light chain (AL) amyloidosis was conducted in order to understand the disease burden, and identify unmet medical needs and knowledge gaps.
  
  
  
  MEDLINE, Embase and Cochrane databases were searched for English language studies published in the last 10 years using search terms that focused on the clinical, economic, and patient-reported outcome (PRO) aspects of AL amyloidosis. There was a low yield of articles in the economic and PRO categories and additional searches were conducted in clinical conference proceedings, and using Google and Google Scholar. After review, there were 65 articles included for data extraction.
  
  
  
  AL amyloidosis is a rare disorder without any FDA or EMA approved indications for drug therapy. Using off-label therapies, there is a high rate, 42-64%, of non-response or progression, and an associated high mortality. Toxicities during therapy are common with estimates of up to 30-40% of patients experiencing severity of grade 3 or higher. Patients with AL amyloidosis report severe psychological distress, anxiety and clinical depression.
  
  
  
  There is a deficiency in the literature on the economic costs associated with AL amyloidosis, and information on costs has been derived from studies that examined multiple myeloma or other disease or treatment components common to AL amyloidosis.
authors.affiliation: a Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited , Cambridge , MA , USA.
authors.forename: Huamao Mark
authors.initials: HM
authors.lastname: Lin
authors.affiliation: b Pharmerit International , Bethesda , MD , USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
authors.affiliation: b Pharmerit International , Bethesda , MD , USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Cooke
authors.affiliation: a Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited , Cambridge , MA , USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Berg
authors.affiliation: a Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited , Cambridge , MA , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Labotka
authors.affiliation: a Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited , Cambridge , MA , USA.
authors.forename: Douglas V
authors.initials: DV
authors.lastname: Faller
authors.affiliation: a Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited , Cambridge , MA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Seal
authors.affiliation: c Medical College of Wisconsin , Milwaukee , WI , USA.
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Hari
mesh_terms: D000686:Amyloidosis / Q000453:epidemiology*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D006801:Humans; D000075363:Immunoglobulin Light-chain Amyloidosis / Q000453:epidemiology*; D009101:Multiple Myeloma / Q000453:epidemiology
keywords: Drug therapy; health economics; patient-reported outcomes; stem cell transplant; unmet medical needs