Znaczenie oceny minimalnej choroby resztkowej w amyloidozie AL

Abstract

Light chain amyloidosis (AL amyloidosis) is a systemic disease leading to organ damage due to deposition of amyloid fibers arising from accumulation of amyloid precursors – monoclonal immunoglobulin light chains produced by clonal bone marrow plasmocytes. The aim of AL amyloidosis therapy is the inhibition amyloidogenic immunoglobulin light chains, what should result in stabilization or often even improvement of involved organs’ function. Treatment effectiveness evaluation is based on hematological and organ response. Despite achievement of complete hematological remission, in some of the patients even a trace number of plasmocytes persisting following treatment may lead to production of low amount of monoclonal immunoglobulins capable of deepening organ damage. These plasmocytes remain undetectable to routine diagnostic approaches and are regarded as minimal residual disease (MRD). Considering the results of the so far published research, it is possible that MRD assessment based on flow cytometric technique may constitute a basic tool of response assessment of AL amyloidosis treatment in the future. In this publication the methodology and results of latest research concerning MRD assessment in AL amyloidosis are presented.