What do you do when amyloidosis goes into remission?

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What do you do when amyloidosis goes into remission?

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so amyloidosis can go into remission much like multiple myeloma, which we know means it's under control and not cured in most cases, but under control.

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And in amyloidosis. It's we look at a lot of the same things that we do in multiple myeloma, but there is an added layer to it when we talk about remission. And a lot of that has to do with the fact that in multiple myeloma remission is really based primarily on those myeloma proteins that are in the blood and the bone marrow biopsy,

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meaning that as we see patients respond in multiple myeloma, we see M spike or light chain proteins drop.

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We may do a bone marrow biopsy and that's a lot of how we determine response or remission in multiple myeloma and amyloidosis we look at the same, we look at the proteins, the light chain proteins primarily we may do bone marrow biopsy and we call that hematological response, basically blood response, which just refers to how much have we suppressed that bad protein that drives the disease.

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But then again, on the other side of the coin, the other component to monitoring remission in amyloidosis is what we call organ response. And Oregon response refers to the fact that Amyloidosis again loves to cause problems in the heart, the kidneys, other organs, and a lot of times when patients respond or in remission with their amyloidosis, that means that their blood proteins are suppressed.

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The light chains are suppressed most often, but they can still feel awful and have life threatening complications because these organs are still impaired. And it takes often months, to years for those organs to actually heal up. And so that's an equally, if not even more important aspect of monitoring amyloidosis, which is to say, how are the organs doing?

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You know, we've suppressed the light chains, but is the heart getting better? Are the kidneys getting better?

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we monitor all of that as part of organ response or organ remission in amyloidosis also and looking for that just depends on the organ that's actually involved. So if we're looking at the heart, we look at echocardiogram, for example, or we look at some of the blood tests that we can use to monitor heart damage.

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So there's one NT- probnp, which is a protein that's often elevated in cardiac amyloidosis. Troponin is another protein that we can use to monitor cardiac amyloidosis.

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And then for kidney involvement, for example, it's a lot of monitoring of urine studies. So in kidney amyloidosis, patients often have quite a bit of this of

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of proteins that leak from the blood into the urine.

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You can often see very high levels of that. And then as the kidneys heal up from amyloidosis, you can actually watch that protein drop. So you essentially see what the pattern of injury is. And as it gets better, then you know that those organs are actually healing up from the damage caused by amyloidosis. So really key to monitoring amyloidosis is the blood work, much like we do on multiple myeloma.

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But then this added level of monitoring the organ function to see how much the organs are healing up

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with the successful treatment.