AL (Primary)
Social Worker
Social workers assist a range of patient populations and provide services in areas including mental health conditions and addictions, chronic disease, children and youth illnesses, geriatrics illnesses, grief, trauma, parenting issues, palliative care, dementia and other neurological issues, financial stressors, housing issues and a broad range of other general psychosocial issues (Ashcroft et al. 2018; McGregor …
Low QRS voltages (LQRSVs) (Cardiac Amyloidosis)
Typical ECG of a patient with cardiac AL amyloidosis showing low QRS voltages in the limb leads and pseudoinfarction pattern in the chest leads. (from Updates in Cardiac Amyloidosis: A Review; Banypersad S et al; J Am Heart Assoc 2012)
Tingling Sensation in the Hands and Feet (Amyloid Neuropathy)
Peripheral neuropathy is a common manifestation of AL amyloidosis, and the incidence of peripheral neuropathy in AL amyloidosis varies from 9.6 to 35% (3–5). The typical pattern of amyloid neuropathy is symmetrical, length-dependent, lower-limb predominant, slowly progressing polyneuropathy, with severe pain. [source: NIH]
Dexamethasone (Ozurdex, Maxidex)
The use of cyclophosphamide (Cy), bortezomib (Bor), and dexamethasone (D), the CyBorD regimen, to treat AL amyloidosis, caused by a non-immunoglobulin M (IgM) monoclonal gammopathy, has significantly improved survival outcomes [10]: CyBorD results in a complete hematologic response of 71% and a 1-year OS of 65%
Melphalan (Alkeran)
Melphalan belongs to the group of medicines called alkylating agents (cancer medicines). It works by interfering with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal cells may also be affected by melphalan, other unwanted effects will also occur.
Enlarged Tongue (Macroglossia) – Sometimes with rippled edges
An enlarged tongue (macroglossia) can be a sign of amyloidosis. It can sometimes also appear rippled along its edge.
Daratumumab (Darzalex®)
Daratumumab is an anti-cancer monoclonal antibody medication. It binds to CD38, which is overexpressed in multiple myeloma cells. In May 2018, the U.S. Food and Drug Administration (FDA) approved daratumumab for use in combination with bortezomib, melphalan and prednisone to include the treatment of people with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant. [source:wikipedia]