Who knows how to treat systemic light chain amyloidosis?

A rarely noted aspect of the era of novel agents and explosive new knowledge in the clonal plasma cell diseases is how short the half-life of relevant information has become, and how this churning has challenged clinical thinking.[1] We may, at times, lose sight of a core concept in the treatment of patients with clonal plasma cell diseases: that baseline risk to patient survival derives from two sources, the genetic endowment of the clonal cell population on the one hand, and the end organs damaged or under attack by the clone on the other.[2,3] These are the issues patients and doctors face at the bedside and in the clinic. They require clear thinking. Clonal plasma cell diseases cause organ damage and symptoms as a result. Emerging knowledge may challenge our categories but not this core concept.