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When abnormal light chains deposit in organs, diagnosis is time-critical
AL amyloidosis is caused by a clonal plasma cell population producing misfolded light chains that deposit in tissues. It can affect the heart, kidneys, liver, nerves and gut. Diagnosis requires tissue confirmation with Congo red staining and typing, plus a search for the plasma cell clone. Treatment aims to suppress the clone and preserve organ function.
Haematology & Haemato-Oncology
Authored and reviewed by Dr. Sachita Baniya (MBBS, FCPS (Clinical Haematology), NMC 20158). Evidence-based, no fabricated outcomes.
AL amyloidosis is caused by a clonal plasma cell population producing misfolded light chains that deposit in tissues. It can affect the heart, kidneys, liver, nerves and gut. Diagnosis requires tissue confirmation with Congo red staining and typing, plus a search for the plasma cell clone. Treatment aims to suppress the clone and preserve organ function.
Reviewed by Dr. Sachita Baniya, MBBS, FCPS — Consultant Haemato-Oncologist & Clinical Hematologist (NMC 20158). For evaluation, contact the respective hospital or cancer centre — Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital Kathmandu, or Advanced Care Hospital.
Presentation may include nephrotic-range proteinuria, heart failure with preserved ejection fraction, neuropathy, macroglossia or unexplained hepatomegaly. Diagnosis requires tissue biopsy with Congo red staining and mass spectrometry or immunohistochemistry for typing. Serum and urine protein studies, free light chains and bone marrow assessment identify the clone.
Treatment targets the underlying plasma cell clone, using regimens similar to myeloma but adapted to organ function and frailty. Cardiac involvement requires careful fluid and rhythm management. Autologous transplant is considered in selected fit patients. Response is monitored with free light chains and organ-specific measures. Early diagnosis is important because advanced cardiac involvement limits options.
Guidelines referenced:
International Society of Amyloidosis consensus recommendationsNCCN Guidelines — Systemic AmyloidosisInternational Myeloma Working Group response criteriaContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.