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Case Reports in Medicine
Volume 2014, Article ID 627474, 6 pages
Case Report

Effectiveness of Bortezomib in Cardiac AL Amyloidosis: A Report of Two Cases

1Department of Medicine, Nephrology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy
2Hematology and Transfusional Service, St. M. Annunziata Hospital, ASL 10, Florence, Italy
3Cardiology Unit, St. M. Annunziata Hospital, ASL 10, Florence, Italy

Received 6 October 2013; Revised 3 February 2014; Accepted 5 February 2014; Published 10 March 2014

Academic Editor: Michael S. Firstenberg

Copyright © 2014 Santi Nigrelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cardiac involvement is a major prognostic determinant in patients with primary AL amyloidosis. The clinical results of standard therapeutic approaches are suboptimal. It has been recently shown that bortezomib, an inhibitor of the proteasome, can induce rapid favourable responses in AL amyloidosis improving cardiac function and survival. Herein we report on two patients with cardiac amyloidosis treated by bortezomib who experienced partial or total remission of hematologic disease and of cardiac involvement. However, death of one patient, suffering from chronic kidney disease stage 5, due to fulminant respiratory syndrome suggests the need for caution in bortezomib use if patients have this comorbid condition.