Modern treatment of amyloidosis: unresolved questions.

During the past 10 to 15 years, there has been substantial progress in developing new treatments for the systemic amyloidoses. These advances have improved patient outcomes but have also raised new questions with direct clinical implications. For example, development of less intensive treatments for AL amyloidosis has made less certain the role of autologous stem cell transplantation, and new quantitative assays should now allow determination of the importance of fully eliminating amyloidogenic light chain production in AL disease. Additionally, observations from a clinical trial in AA amyloidosis have generated hypotheses about the relative contributions of amyloid precursors and mature fibrils to amyloidosis-associated kidney disease.