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

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.