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EBMT 2025 | Early diagnosis of AL amyloidosis in patients with MGUS: the importance of screening
In this video, Kiavasch Farid, MD, Heidelberg University Hospital, Heidelberg, Germany, briefly comments on the need to monitor patients with monoclonal gammopathy of undetermined significance (MGUS) to allow for early detection of progression to light chain (AL) amyloidosis. Dr Farid emphasizes the importance of yearly screening, including checking serum parameters such as NT-ProBNP and alkaline phosphatase, as well as monitoring for albuminuria, to help detect disease progression. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
So I think the most unfortunate cases are the ones where the monoclonal gammopathy is known beforehand. So it’s called monoclonal gammopathy of undetermined significance, but the patients aren’t screened very well for these monoclonal gammopathies of clinical significance, and one of them is AL amyloidosis, obviously. So most people are just looking for progression to a smoldering myeloma or myeloma itself...
So I think the most unfortunate cases are the ones where the monoclonal gammopathy is known beforehand. So it’s called monoclonal gammopathy of undetermined significance, but the patients aren’t screened very well for these monoclonal gammopathies of clinical significance, and one of them is AL amyloidosis, obviously. So most people are just looking for progression to a smoldering myeloma or myeloma itself. They’re checking for the CRAB criteria. But it’s very important to keep in mind that a fraction of these patients also can develop AL amyloidosis. And what’s really important is to do screening. We recommend yearly screening that includes serum parameters like NT-ProBNP and to check for albuminuria which is very important and also serum alkaline phosphatase for early signs of hepatic involvement. And when you check these once a year, there is a near 100% chance you will get the diagnosis of AL amyloidosis as early as possible which is crucial to successful treatment.
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Disclosures
Travel Grants: Pierre Fabre and Kite/Gilead.
