[Recommendations for the treatment of AL amyloidosis].

Autor:	Brulc EB; Servicio de Clínica Médica, Sección de Hematología, Hospital Italiano de Buenos Aires, Argentina., Carretero M; Servicio de Clínica Médica, área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Argentina. E-mail: marcelina.carretero@hospitalitaliano.org.ar., Aguirre MA; Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina., Negro A; Instituto Universitario del Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina., Ulacia MD; Instituto Universitario del Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina., Perez de Arenaza D; Servicio de Cardiología, Hospital Italiano de Buenos Aires, Argentina., Villanueva E; Servicio de Cardiología, Hospital Italiano de Buenos Aires, Argentina., Sáez MS; Laboratorio Central, Sección Proteínas, Hospital Italiano de Buenos Aires, Argentina., Sorroche P; Laboratorio Central, Sección Proteínas, Hospital Italiano de Buenos Aires, Argentina., Posadas Martínez ML; Consejo Nacional de Investigaciones Científicas y Técnica, Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Argentina., Nucifora EM; Servicio de Clínica Médica, Sección de Hematología, Hospital Italiano de Buenos Aires, Argentina.
Jazyk:	Spanish; Castilian
Zdroj:	Medicina [Medicina (B Aires)] 2022; Vol. 82 (4), pp. 591-604.
Abstrakt:	Introduction: Immunoglobulin light chain (AL) amyloidosis is a rare disease. Treatment is challenging, justified in part by systemic compromise and limited scientific evidence. Objectives: Develop evidencebased recommendations that allow adequate treatment of patients with amyloidosis AL. Methods: A list of PICO format questions focused on the effectiveness and safety of amyloidosis AL treatment was generated. PubMed, Cochrane and Epistemonikos were searched. The levels of evidence and grades of recommendation were based on the GRADE system. Results: 11 recommendations were generated. In selected patients with amyloidosis AL, autologous hematopoietic stem cell transplantation (ASCT) is recommended after induction with bortezomibbased regimens and conditioning with melphalan, since it could deepen the hematological and organ response, its durability and improve survival. In patients not eligible for ASCT, first-line treatment with bortezomib-based regimens is recommended, since it is likely to achieve a higher rate of hematological and organ response and improve survival. In patients with a contraindication or inaccessibility to bortezomib, treatment with alkylating agents and corticosteroids is recommended, since they are likely to achieve haematological and organ response and improve survival. Discussion: These treatment recommendations are based on the available evidence and the experience of the panel of experts, in a scenario of limited available resources, according to developing countries.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu