AMY DA site - i can understand - tab Improved awareness journey - video 1 inside fragment

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Chapters

  • 00:00:15
    Diagnosing AL amyloidosis early,
  • 00:00:18
    it relies on increasing awareness.
  • 00:00:22
    Once you have unexplained nephrotic syndrome
  • 00:00:25
    unexplained congestive heart failure, unintentional weight loss,
  • 00:00:29
    peripheral and autonomic neuropathy, and even acquired Factor X deficiency
  • 00:00:35
    leading to coagulopathy, the suspicion
  • 00:00:39
    for AL amyloidosis should be high.
  • 00:00:47
    The therapeutic landscape for systemic AL amyloidosis
  • 00:00:51
    has changed and expanded dramatically
  • 00:00:55
    in the last 20 years, and that is the span of my career.
  • 00:01:00
    So the treatments are twofold.
  • 00:01:01
    The first is the definitive treatment
  • 00:01:04
    attacking the plasma cell dyscrasia
  • 00:01:07
    and the second treatment is the supportive treatment
  • 00:01:10
    is based on expertise from subspecialties
  • 00:01:15
    to make patients’ quality of life better
  • 00:01:19
    by controlling congestive heart failure
  • 00:01:22
    and nephrotic syndrome and autonomic neuropathy.
  • 00:01:26
    But the treatments that are directed towards
  • 00:01:29
    the plasma cell dyscrasia reduces the production
  • 00:01:32
    of the amyloidogenic light chains to improve the organ dysfunction
  • 00:01:37
    and, hence, improve the outlook and prognosis of patients with AL amyloidosis.
  • 00:01:44
    Even before you start treatment,
  • 00:01:46
    multidisciplinary collaboration is key in figuring out
  • 00:01:50
    if a patient is a candidate for aggressive treatment.
  • 00:01:55
    And I think—we do this every Friday at the Amyloidosis Center
  • 00:01:58
    here where we sit down, and we discuss every patient.
  • 00:02:00
    And Dr. Sanchorawala will ask us as cardiologists
  • 00:02:05
    do you think this patient can tolerate the treatment that I’m thinking of?
  • 00:02:08
    Do you think this patient can tolerate
  • 00:02:10
    aggressive treatment because of their heart involvement?
  • 00:02:13
    So, I think the cardiologist takes a really important role
  • 00:02:16
    in figuring out if a patient is a candidate
  • 00:02:19
    for aggressive anti-plasma cell treatment
  • 00:02:21
    or for modifying that treatment
  • 00:02:24
    so that they are candidates for treatment.
  • 00:02:32
    I’m sort of really impressed by how far we’ve come in this field,
  • 00:02:34
    and I think that there is real promise
  • 00:02:37
    to take this disease that used to be uniformly fatal
  • 00:02:41
    and convert it into more of a chronic disease that we can manage.
  • 00:02:46
    Really the next step in this treatment, in this disease,
  • 00:02:48
    is to figure out how to prevent
  • 00:02:50
    progression of the organs that are involved.
  • 00:02:53
    Remember, that you're working on 2 levels here.
  • 00:02:56
    You're working at the level of a plasma cell dyscrasia
  • 00:02:59
    for bone marrow disorder, but then, this
  • 00:03:02
    amyloid protein is depositing in organs and causing organ failure,
  • 00:03:05
    heart failure, kidney failure, nervous system problems, GI problems.
  • 00:03:10
    I think that’s really where the future is,
  • 00:03:11
    and there's a lot of interesting developing things like that
  • 00:03:14
    when somebody develops signs of organ damage,
  • 00:03:17
    you know, how do you reverse that?
  • 00:03:19
    And I think that is going to be the next frontier for us.