Background: A total of 50% of patients with AL amyloidosis have t(11;14) translocation, allowing us to use the selective oral BCL-2 inhibitor venetoclax in their treatment. Case presentation: Our patient was admitted to the gastroenterology department due to weight loss and abdominal pain. An abdominal CT scan revealed some enlarged lymph nodes; therefore, he was referred to the hematology department. A bone marrow biopsy showed massive amorphous amyloid deposition. The sample was positive on Congo red staining and exhibited double refraction under a polarized light microscope. Serum-free light chains and the difference between involved and uninvolved free light chains (dFLCs) were elevated. Using fluorescent in situ hybridization, we detected t(11;14) translocation. Further examinations confirmed the involvement of the liver, colon and heart. Stage II AL amyloidosis was confirmed. Our patient received combined induction therapy with CyBorD and venetoclax due to the presence of the t(11;14) translocation. After six cycles, the patient achieved complete remission. Autologous stem cell transplantation (ASCT) was performed. At 100 days post-ASCT, the patient had complete hematologic remission. Venetoclax maintenance treatment was initiated. The follow-up examinations showed that the patient is in very good partial remission. Conclusions: In the case of our AL amyloidosis patient with t(11;14) translocation, the combined treatment with CyBorD and venetoclax was well tolerated and effective.

Background: 50% of patients in AL amyloidosis have t(11;14) translocation, allowing to use the selective, oral BCL-2 inhibitor venetoclax in their treatment. Case presentation: Our patient was admitted to the Gastroenterology Ambulance due to weight loss and abdominal pain. An abdominal CT scan revealed some enlarged lymph nodes, he was referred to the Hematology Ambulance. Bone marrow biopsy showed massive amorphous amyloid deposition. The sample was positive with Congo red staining and exhibited double refraction under polarized light microscope. Serum free light chains and the difference between involved and uninvolved free light chains (dFLC) were elevated. Fluorescent in situ hybridization detected t(11;14) translocation. Further examinations confirmed the involvement of the liver, colon and heart. Stage II. AL amyloidosis was confirmed. Combined chemotherapy was initiated with Venetoclax due to the presence of the t(11;14) translocation. After six cycles, the patient achieved complete remission. Autologous stem cell transplantation (ASCT) was performed. At 100 days post-ASCT, the patient had complete hematologic remission. Venetoclax maintenance treatment was initiated. Follow-up examinations are showing that the patient is in very good partial remission. Conclusions: In case of our AL amyloidosis patient with t(11;14) translocation the combined treatment of CyBorD and venetoclax was well tolerated and effective.