What is your approach to a patient with systemic AL amyloidosis who has achieved a hematologic response but not an organ response with CyBorD?
Would you proceed to autologous transplant, or switch to an alternate regimen (eg. daratumumab-based) first?
Would the type or degree of organ involvement affect your decision?
Answer from: Medical Oncologist at Academic Institution
I would leave them alone. Treating to organ response is wrong and dangerous. Hematologic response is quick, organ response is delayed. The goal is hematologic remission; after that allow the body the time needed to heal the organs.