Role of a Multidisciplinary Program (Amyloidosis Program of Calgary) on Recognition and Intervention for AL and ATTR Amyloidosis.

Abstract

Background: The diagnosis and management of amyloidosis requires strong coordination among various teams and a multidisciplinary approach which is essential for providing the diagnostic tools needed for patients with organ amyloid deposition.

Methods: In this study, we reviewed the referral patterns to the cardiac and hematology amyloid clinics since the inception of the Amyloidosis Program of Calgary (APC) in 2019. The APC was established to facilitate the diagnosis and treatment of amyloidosis. Additionally, a central referral system was created to expedite the triage of cases with potential amyloid-related symptoms.

Results: The cardiac amyloid clinic saw an increase in referrals from 41 in 2018 to 105 in 2022, although there was a temporary decrease from 67 in 2019 to 56 in 2020 during the first year of the pandemic. Most referrals came from nonamyloid cardiology clinics, followed by hematology referrals. Fifty percent of the cases referred were patients with ATTR and 18% represented AL cases. Moreover, amyloid clinic at our cancer center also began receiving referrals via the central triage system in 2019, with AL amyloidosis cases increasing from 16 to 25 between 2018 and 2023. Therefore, we report here the significant impact of the APC on increasing referrals for patients with ATTR, with the program facilitating diagnostic pathways for these rare conditions.

In summary: Since 2022, the establishment of an amyloid screening clinic has furthered these efforts, aiming to enhance early recognition and improve clinical outcomes.