AL Amyloidosis
New AL amyloidosis research, summarized each month in plain language.
2026 so far: So far in 2026, daratumumab-based first treatment was linked to faster, deeper responses, with organ and survival benefits supported by ANDROMEDA plus real-world data. Many reports also showed that organ recovery can lag behind blood response, and that supportive-care tradeoffs stayed important. Read the 2026 review
We also cover clinical trials.
Yearly update
2026 so far
- Daratumumab as first treatment. Real-world studies added support alongside ANDROMEDA's survival and organ-worsening advantages.
- Relapse treatment options. BCMA approaches expanded, while safety centered on infections and CRS.
- Heart supportive medicines. Supportive heart-drug signals emerged, but causality stayed uncertain.
- Blood vs organ recovery. Multiple studies clarified delayed and incomplete organ improvement timelines.
- Liver and kidney tracking. Routine labs and biopsy/imaging features were tied to outcomes.
New
September 2026
- Daratumumab alone. In relapse, abnormal blood proteins often fell with daratumumab alone.
- Anselamimab add-on. Responses were reported; serious health problems were common but judged unrelated to the antibody.
- Heart-failure medicines. Linked to lower death rates, but more hospital and kidney problems.
- Amyloid type confirmation. Mass spectrometry on biopsy helped resolve mismatched test results.
August 2026
- Steroid duration. Shorter dexamethasone use had similar later responses, with fewer side effects.
- Daratumumab add-on. With shorter steroids, daratumumab was linked to more complete responses.
- Survival risk markers. Lower blood pressure and 1q gain were linked to worse survival.
- Testing and biopsy. Blood tests and imaging could be unclear, so biopsy often confirmed.
July 2026
- Daratumumab dosing. Less frequent dosing still showed strong early blood-marker responses.
- Antihistamine choice. A non-sedating antihistamine was linked to less drowsiness.
- BCMA therapies. BCMA-targeted treatments often had high responses, with different side effects.
- Kidney biopsy signals. Some biopsy findings were linked to higher dialysis risk.
June 2026
- Frontline treatment. Daratumumab regimens were linked to faster, deeper blood marker responses.
- Early heart risk. With advanced heart involvement, early death risk remained substantial.
- Relapse treatments. BCMA therapies often gave deep blood responses, with frequent infections.
- Understanding the limits of common lab tests. Different tests and daratumumab can affect lab result readings.
May 2026
- Daratumumab and responses. Across reports, daratumumab-based treatment was linked to deeper blood protein control and higher organ response rates.
- Amyloid-clearing antibody in advanced heart disease. In people with advanced heart involvement, an amyloid-clearing antibody did not improve the main heart outcome overall, with results differing by light-chain type.
- Earlier heart detection. Earlier recognition of heart involvement was linked to combining clinical and lab data with imaging and using confirmatory scans when needed.
- Early measures and later outcomes. Early blood and organ response measures were used to estimate later kidney and heart outcomes.
April 2026
- Early CAR-T experience. In a very small CAR-T report, blood responses and kidney improvement were seen quickly.
- Early safety signals. Early CAR-T side effects were mostly mild in this report, but longer follow-up is needed to understand less common or later risks.
- Combining blood and urine tests. Detection improved when blood and urine protein tests were used together.
- When heart recovery happens. In cardiac AL, blood responses often appeared earlier than measurable heart biomarker improvement, which was uncommon.
March 2026
- Deeper blood responses. In advanced cardiac AL amyloidosis, more people were reported to reach deep blood (light-chain) responses with longer follow-up.
- SGLT2 inhibitor use. In observational data, use of SGLT2 inhibitors was associated with better outcomes in AL amyloidosis patients with heart failure, but this does not prove the drug caused the difference.
- Heart risk grouping. Heart imaging measures and a short-term risk score were used to sort people into different risk groups.
- Free light-chain test variation. Different free light-chain blood tests sometimes produced different results for the same person.
February 2026
- Deeper blood response, better outcomes. Across studies, stronger control of the light‑chain–producing cells tended to line up with better outcomes, and organ improvement was often reported alongside deep blood responses in routine care.
- Confirming the amyloid type. Delays were still common before AL amyloidosis was confirmed, and in two case reports genetic testing showed that amyloid first thought to be AL was actually a hereditary type.
- Markers associated with higher risk. More bone marrow plasma cell involvement and coexisting multiple myeloma were associated with shorter survival, and some newer heart imaging measures were also linked to risk but with low certainty.
January 2026
- First treatment response. In a matched real‑world comparison, daratumumab‑based first therapy was linked to faster and deeper blood (light‑chain) responses, with earlier heart and kidney improvement also reported.
- Liver response and AF risk. Studies used months‑long changes in alkaline phosphatase to define liver response (which aligned with survival), and a separate score estimated who was more likely to develop atrial fibrillation.
- Heart imaging and amyloid typing. Cardiac MRI and ECG‑based calculations showed specific accuracy patterns for assessing heart involvement or separating look‑alike conditions, while case reports highlighted the need to confirm amyloid type carefully.
- Why organs respond differently. Genetic and tissue studies linked light‑chain features to different organ patterns, and lab work tested small molecules that stabilized light‑chain proteins without showing patient benefit yet.
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