Part 3: Diagnosis and Management of Immunoglobulin Light Chain Amyloidosis

Jason S. Starr, DO

Hematology/Oncology Fellow, Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL

Taimur Sher, MD

Assistant Professor of Medicine, Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL

Question 3

The diagnosis of AL amyloidosis is confirmed and the patient is diagnosed with stage I cardiac disease. He elects to proceed with high-dose chemotherapy and autologous stem cell rescue. However, he continues to have mucocutaneous bleeding and requires frequent transfusion of fresh frozen plasma (FFP). What should be done next?

  •   Continue FFP transfusions, add aminocaproic acid, and proceed with the
    stem cell transplant
  •   Proceed with stem cell transplant as the bleeding will improve with chemotherapy
  •   Perform splenectomy and then proceed with stem cell transplant after
    coagulopathy improves
  •   Inform the patient that he is not a candidate for stem cell transplant

Updated 8/21/2013 • jdw | Copyright ©2014 Turner White Communications