Episode 26 - Trip to the Congo | Amyloidosis Overview

12/03/24 • 35 min

MGUS and Myeloma too simple for your tastes? Do you like vague presentations and biopsying many tissues in a sometimes wild goose chase? Why does Congo have all the birefringent apples? Go 'AAaah' as we TTRy to unpack ALl the problems that come with that most protean of disease - Systemic Amyloidosis!
Timestamps
3:04 - Pathophysiology of Amyloid
6:52 - All The Subtypes of Amyloid
7:56 - AA Amyloid
10:08 - ABeta2M Amyloid
11:04 - Age-Related Amyloidosis = wtATTR = WTTA = SSA
14:38 - AL Amyloidosis
16:24 - Diagnosis of Amyloid
22:25 - Clinical Presentation of Amyloid
27:10 - Prognosis
32:17 - Take Home Messages

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Previous Episode

Episode 25 - Alphabet Soup | Overview of Myeloma Treatments

RVd, KTd, CyBorD, DVd, EloRd - Looks like the cat got on the keyboard. Oh wait, this is just the myeloma regimens in day therapy today.
Come on a journey as we attempt (mostly successfully) to avoid drug trade names! Let go of your proteasome inhibitions, phenotype your red cells and let us modulate your understanding of what it is to treat myeloma with an alphabet soups worth of drugs. We sincerely apologise to our endocrinology colleagues for how much dexamethasone we use in this episode but also generally.
Timestamps
4:00 - Overview of the treatment journey
9:49 - Steroids - not the bulking kind
13:54 - Immunomodulators - the IMiDs
19:46 - Proteasome inhibitors - Bortezomib, Carflizomib
24:45 - Monoclonal antibodies - Daratumumab, Elotuzumab
28:31 - SINE Inhibitor - Selinexor
29:27 - Antibody-drug conjugates - Belantamab mafodotin
30:27 - CELMoDs - Iberdomide, mezigdomide
31:06 - Standard chemotherapy
33:15 - Autologous stem cell transplant
38:21 - T-cell directed therapy - BiTes, CAR-T
40:57 - Supportive care

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Next Episode

Episode 27 - In The Lab: Electrophoresis, Immunoelectrophoresis and Serum Free Light Chain Assays

Thought you were free of myeloma acronyms? Don’t be ridiculous - this is the haematology lab! We were born in the acronyms, moulded by them. We didn’t see a complete word until advanced training and even then it was nothing but BLINDING. Your lab tests betray you because they belong to us... but in this episode we’ll let you in on some secrets. Join Nick, Cale and Bashar in the haematology (and closely adjacent immunology) lab as they chat about just how we do that electrophoresis, why an iEPG is different to an EPG and just how useful Bence-Jones proteins are(n’t).
Timestamps
3:15 - Bone marrows - not as bad as they sound?
4:25 - What even do we do with the marrow?
10:57 - Eponymous plasma cells with weird morphology
13:04 - EPG - Electrophoresis
22:23 - IEPG - Immunoelectrophoresis
29:09 - What's the deal with Bence Jones proteins
33:27 - SFLC Measurements
37:07 - The Hook/Prozone Effect
40:55 - Light chain measurement in renal dysfunction
44:32 - Take Home Messages

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au