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Amyloid light chain (AL) amyloidosis is a rare, monoclonal plasma-cell disorder that results from infiltration of the kidneys, heart, liver, and peripheral nerves by deposits of immunoglobulin light chain fragments. Standard therapy is similar to that used for multiple myeloma: melphalan and dexamethasone. However, bortezomib (Velcade), a newer agent that is active in myeloma, is also being tested in patients with AL amyloidosis.
In an industry-funded, multinational, phase I/II study, a total of 70 previously treated patients with AL amyloidosis were selected to receive bortezomib if they had Karnofsky scores ≥70%; creatinine clearance ≥40 mL/minute; cardiac ejection fraction ≥40%; and adequate hematologic, hepatic, and renal function. In th…