How would you approach management and monitoring of AL amyloidosis with isolated renal involvement?

This is tough for sure, and my first question would be to ask how the renal biopsy was determined to be AL amyloidosis. Sometimes typing isn't required if the pattern is overwhelmingly lambda-restricted or kappa-restricted by immunofluorescence... but in this case, mass spectrometry typing may be wo...

Assuming the diagnosis is correct, my preference is to approach management with Dara-CyBorD induction as in ANDROMEDA followed by Dara maintenance. Upfront ASCT is reasonable in cases of renal-only amyloidosis, though with 10-15% disease, I would favor induction anyhow.

For disease monitoring, 24-hou...