The Best Treatment for Amyloidosis With Multiple Myeloma

Amyloidosis is a blood disorder characterized by the production of amyloid, an abnormal protein that accumulates in various organs and seriously degrades their function. Organs that are commonly affected include the liver, kidneys, heart, spleen and nervous system. For reasons that are not clear, amyloidosis sometimes occurs in association with the bone marrow cancer called multiple myeloma. The best current treatment options in these cases are chemotherapy and a procedure called peripheral blood stem cell transplantation.

Understanding Amyloidosis

• According to the University of California, San Francisco Medical Center, amyloidosis occurs in roughly 10 percent of multiple myeloma cases. In these circumstances, it is referred to as primary amyloidosis. While the exact cause for its development is unknown, it is worth noting that both myeloma and amyloid proteins result from abnormal bone marrow activity. The degradation in organ function caused by the buildup of amyloids is as serious a threat to the body as myeloma itself, and the Cleveland Clinic cites an average survival time of slightly less than two years from the time of initial diagnosis.

Chemotherapy

• If you are diagnosed with amyloidosis accompanied by multiple myeloma, your doctor may choose from several treatment options to determine which approach is best in your circumstances. Many of these therapies are still under research, and the potential outcomes of your treatment may not be thoroughly understood. According to the Mayo Clinic, a main option for treatment of primary amyloidosis is the combination of the chemotherapy drug melphalan (Alkeran) and the anti-inflammatory corticosteroid dexamethasone.

  You may also be treated with dexamethasone in combination with a number of other chemotherapy agents normally used to treat multiple myeloma without amyloidosis. Examples here include thalidomide (Thalomid), lenalidomide (Revlimid) and bortezomib (Velcade). These medications may also be used without dexamethasone. All of these treatment options carry risk of a number of serious side effects. Ask your doctor to fully explain any medication he may prescribe. Due to the serious nature of both multiple myeloma and amyloidosis, you may also wish to ask your doctor about participating in a clinical trial of newer, experimental treatments.

Peripheral Blood Stem Cell Transplantation

• Your doctor may also choose to treat you with a technique called peripheral blood stem cell transplantation. In this procedure, your doctor will make a transfusion of stem cells (immature blood cells) directly into your affected marrow. These cells are collected in advance, and may come from either your own body or from a donor. Contributions from your body, known as an autologous transplant, are preferable. Be aware that the risks of stem cell transplantation are extreme, and may include death. Additionally, certain factors in your physical condition may make you unsuitable for this form of treatment. While transplantation may have positive results when used in isolation, it is more effective when combined with high-dose chemotherapy.

  Please note that amyloidosis is currently incurable. The goal of treatment is to slow the progress of the disease and provide some increase in the function of your organs. Consult your doctor for additional treatment advice.