Updated recommendations for the treatment of light-chain amyloidosis from the Swiss Amyloidosis Network

Max J Rieger¹, Andreas J Flammer², Sabine Gerull³, Thomas Pabst⁴, Holger W Auner⁵, Kaveh Samii⁶, Felicitas Hitz⁷, Ulrich Mey⁸, Veronika Ballova⁹, Raphael Battegay¹⁰, Giorgia Melli¹¹, Dominik Benz¹², Yakup Yakupoglu¹³, Christoph Gräni¹⁴, Regina Schläger¹⁵, Sarah Hugelshofer¹⁶, Annina Studer¹⁷, Luca Oechslin¹⁸, Adam Bakula¹⁴, Thomas M Suter^{14

19}, Julia Leo-Stickelberger¹, Manuela Averiamo²⁰, Thomas Fehr^{21

22}, Hans H Jung²³, Natallia Laptseva², Robert Manka^{2

12}, Axel Rüfer²⁴, Adrian Schmidt²⁵, Harald Seeger^{26

27}, Beat Müllhaupt²⁸, Simon F Stämpfli²⁹, Carmen De Ramon Ortiz⁶, Marie Théaudin³⁰, Bernhard Gerber^{22

31}, Rahel Schwotzer¹

Affiliations

¹ Department of Medical Oncology and Haematology, University Hospital Zurich, Zurich, Switzerland.
² University Heart Centre, University Hospital, Zurich, Switzerland.
³ Department of Medical Oncology and Haematology, Cantonal Hospital Aarau, Switzerland.
⁴ Department of Oncology, University Hospital Bern, Inselspital, Bern, Switzerland.
⁵ Department of Haematology, Lausanne University Hospital, Lausanne, Switzerland.
⁶ Department of Haematology, University Hospital of Geneva, Geneva, Switzerland.
⁷ Department of Medical Oncology and Haematology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
⁸ Department of Oncology and Haematology, Cantonal Hospital Graubünden, Chur, Switzerland.
⁹ Department of Medical Oncology and Haematology, Cantonal Hospital Baden, Baden, Switzerland.
¹⁰ Department of Haematology, University Hospital Basel, Basel, Switzerland.
¹¹ Department of Neurology and Neurodegenerative Diseases Group, Laboratories for Translational Research, Neurocentre of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹² Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
¹³ Division of Cardiology, Cantonal Hospital Aarau, Switzerland.
¹⁴ Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
¹⁵ Department of Neurology, University Hospital Basel, Basel, Switzerland.
¹⁶ Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
¹⁷ Department of Internal Medicine, Clinic for Cardiology and Institute for Radiology and Nuclear medicine, Stadtspital Zurich Triemli, Zurich, Switzerland.
¹⁸ Hirlsanden Heart Centre, Zurich, Switzerland.
¹⁹ Lindenhofgruppe, Bern, Switzerland.
²⁰ Cardiocentro Ticino, Lugano, Switzerland.
²¹ Department of Internal Medicine, Cantonal Hospital Graubünden, Chur, Switzerland.
²² University of Zurich, Zurich, Switzerland.
²³ Department of Neurology, University Hospital and University Zurich, Zurich, Switzerland.
²⁴ Department of Haematology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
²⁵ Department of Internal Medicine, Clinic for Medical Oncology and Haematology, Stadtspital Zurich Triemli, Zurich, Switzerland.
²⁶ Institute for Nephrology and Dialysis, Cantonal Hospital Baden, Baden, Switzerland.
²⁷ Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
²⁸ Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
²⁹ Heart Centre Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland.
³⁰ Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
³¹ Clinic of Haematology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

PMID: 40811214
DOI: 10.57187/s.4219

Free article

Updated recommendations for the treatment of light-chain amyloidosis from the Swiss Amyloidosis Network

Max J Rieger et al. Swiss Med Wkly. 2025.

Free article

. 2025 Jul 17:155:4219.

doi: 10.57187/s.4219.

Authors

Affiliations

¹ Department of Medical Oncology and Haematology, University Hospital Zurich, Zurich, Switzerland.
² University Heart Centre, University Hospital, Zurich, Switzerland.
³ Department of Medical Oncology and Haematology, Cantonal Hospital Aarau, Switzerland.
⁴ Department of Oncology, University Hospital Bern, Inselspital, Bern, Switzerland.
⁵ Department of Haematology, Lausanne University Hospital, Lausanne, Switzerland.
⁶ Department of Haematology, University Hospital of Geneva, Geneva, Switzerland.
⁷ Department of Medical Oncology and Haematology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
⁸ Department of Oncology and Haematology, Cantonal Hospital Graubünden, Chur, Switzerland.
⁹ Department of Medical Oncology and Haematology, Cantonal Hospital Baden, Baden, Switzerland.
¹⁰ Department of Haematology, University Hospital Basel, Basel, Switzerland.
¹¹ Department of Neurology and Neurodegenerative Diseases Group, Laboratories for Translational Research, Neurocentre of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹² Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
¹³ Division of Cardiology, Cantonal Hospital Aarau, Switzerland.
¹⁴ Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
¹⁵ Department of Neurology, University Hospital Basel, Basel, Switzerland.
¹⁶ Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
¹⁷ Department of Internal Medicine, Clinic for Cardiology and Institute for Radiology and Nuclear medicine, Stadtspital Zurich Triemli, Zurich, Switzerland.
¹⁸ Hirlsanden Heart Centre, Zurich, Switzerland.
¹⁹ Lindenhofgruppe, Bern, Switzerland.
²⁰ Cardiocentro Ticino, Lugano, Switzerland.
²¹ Department of Internal Medicine, Cantonal Hospital Graubünden, Chur, Switzerland.
²² University of Zurich, Zurich, Switzerland.
²³ Department of Neurology, University Hospital and University Zurich, Zurich, Switzerland.
²⁴ Department of Haematology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
²⁵ Department of Internal Medicine, Clinic for Medical Oncology and Haematology, Stadtspital Zurich Triemli, Zurich, Switzerland.
²⁶ Institute for Nephrology and Dialysis, Cantonal Hospital Baden, Baden, Switzerland.
²⁷ Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
²⁸ Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
²⁹ Heart Centre Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland.
³⁰ Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
³¹ Clinic of Haematology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

PMID: 40811214
DOI: 10.57187/s.4219

Abstract

Since the publication of the first Swiss recommendations on systemic light-chain amyloidosis in 2020, treatment strategies have evolved. As a result of the third joint meeting of the Swiss Amyloidosis Network, a multidisciplinary and multicentre Swiss clinical consortium, in 2024, recommendations for the treatment of light-chain amyloidosis were updated. They discuss the role of the new standard first-line protocol Daratumumab, Cyclophosphamide, Bortezomib, Dexamethasone (Dara-CyBorD), the timing and indication of high-dose treatment and potential second-line strategies as well as emerging treatment options, with a special focus on multidisciplinary supportive care measures. The update represents a synopsis of current evidence and expert consensus and intends to provide general treatment guidance tailored to the Swiss healthcare system. Nonetheless, treatment decisions should always be personalised and involve a multidisciplinary approach. This update replaces the previous "therapeutic recommendations" while the previous "diagnostic recommendations" remain valid.

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Updated recommendations for the treatment of light-chain amyloidosis from the Swiss Amyloidosis Network

Affiliations

Updated recommendations for the treatment of light-chain amyloidosis from the Swiss Amyloidosis Network

Authors

Affiliations

Abstract

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Research Materials