Table 5.
Common Chemotherapy/Immunotherapy Agents in AL Amyloidosis
| Examples | First Line? | Notable Toxicities | |
|---|---|---|---|
| Steroids | Dexamethasone, prednisone | Yes | Hyperglycemia, neuropsychiatric effects, edema, immunosuppression |
| Alkylators | Melphalan, cyclophosphamide | Commonly | Myelosuppression, stomatitis |
| Proteasome inhibitors | Bortezomib, carfilzomib, ixazomib | Commonly | Neuropathy, thrombocytopenia, shingles reactivation, thrombosis/hypertension/cardiotoxicity (carfilzomib) |
| Immunomodulators | Lenalidomide, pomalidomide | Occasionally | Myelosuppression, rash, neuropathy, thrombosis, birth defects |
| Anti-CD38 Antibody | Daratumumab | No (ANDROMEDA trial investigating) (66) | Infusion reaction, hypogammaglobulinemia |
| Anti-SLAMF7 antibody | Elotuzumab | No | Infusion reaction, hypogammaglobulinemia |