While myeloma is used as a blueprint for treatment of AL amyloidosis, it does not truly reflect its complexity. Dr Anita D’Souza and Dr Kumar discuss the role of clinical trials, the use of autologous stem cell transplant, and how the nature of AL amyloidosis alters response to and side effect profiles of myeloma treatments. Dr D’Souza also offers advice on monitoring treatment response and the steps to take when response is poor.

Dr Anita D’Souza returns to discuss the complex process of identifying and confirming AL amyloidosis. She talks to Dr Kumar about how she uses tests – from blood tests to mass cytometry – in the diagnostic process, why a negative biopsy does not always rule out AL amyloidosis, and why a multidisciplinary approach is critical for good patient outcomes.

AL amyloidosis can present with an astonishing variety of symptoms that masquerade as other diagnoses, making it very easy to miss. Dr Kumar and Dr Anita D’Souza chat about how to recognise when there could be a single underlying cause of accumulating diverse symptoms – and why it’s so important to consider the whole patient to avoid diagnostic delay. Dr D’Souza also talks about strategies for identifying and managing AL amyloidosis coexisting with multiple myeloma.

Linda Perez had 9 years of misdiagnoses before a persistent cardiologist finally realised she had a single underlying disease, by which time she was very ill indeed. She tells Dr Kumar about the huge physical and emotional impact of the disease, the support that patients need from their healthcare team versus what is available, and how different specialists can work together with the patient to successfully manage AL amyloidosis.