Treatments for Amyloidosis

Amyloidosis is a rare group of diseases that are divided into three main types: primary, secondary and familial, or hereditary amyloidosis. Amyloidosis occurs when organs build up too much amyloid protein. Treatment can help limit production of amyloid proteins, reduce symptoms and slow the progression of the disease. Treatments vary according to what type of amyloidosis is present and the underlying condition that needs to be addressed..

Chemotherapy

• Chemotherapy can be given by IV or orally to destroy abnormal plasma cells in the bone marrow. Low-dose oral chemotherapy is the common treatment for amyloidosis. It may be used in combination with other medications such as corticosteroids and anti-inflammatory medicines. The most commonly used chemotherapy drugs include melphalan (Alkeran), bortezomib (Velcade), thalidomide (Thalomid) and lenalidomide (Revlimid).

Immunotherapy

• Immunotherapy, also known as biologic therapy, is used to boost the immune system and slow or prevent the formation of new amyloids. Alpha interferon is given to the patient through an injection. This treatment is used primarily for primary amyloidosis and multiple myeloma cancer.

Stem cell transplantation

• Stem cell transplantation replaces bone marrow cells that make amyloid proteins with healthy bone marrow cells that will not make the proteins. There are two types of stem cell transplantation: allogeneic (ALLO) and autologous (AUTO). The ALLO transplant uses donor stem cells that match the patient's stem cells genetically.

  Typically a family member such as a brother or sister will be the donor, but unrelated people can match in some cases. AUTO treatment uses the stem cells of the patient. Healthy stem cells are taken from the patient once other treatment has stopped formation of amyloid proteins. The healthy stem cells are frozen until it is time for transplantation. For both treatments, high-dose chemotherapy is used to destroy all the abnormal plasma cells and suppress the immune system so the healthy stem cells from a donor are not rejected by the patient's body.

Dietary therapy

• Amyloidosis can be treated through diet if it's affecting certain organs and will help reduce the production of amyloid proteins in the patient's body. If a patient's heart or kidneys are being affected by amyloidosis, the physician may order a low-sodium diet. Foods that contain caffeine, additives and refined sugars should be avoided as well as processed foods and dairy products. To eat healthier, more whole grains, fresh fruits and vegetables should be included in the diet.

Surgery

• An organ transplant may be considered as a surgical option if there is enough damage to the heart and kidneys. It is possible the amyloid proteins may build up again in the new organs over time. Some amyloid protein deposits can be removed from the body and surgery can also treat hereditary amyloidosis by relieving nerve pressure.