**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Shahrier Hossain, Dana-Farber Cancer Institute, Boston, Massachusetts

**Main Body of the Abstract**
Background: Bortezomib is a reversible proteasome inhibitor that is a mainstay of treatment of plasma cell disorders, including AL amyloidosis. Ocular toxicity is a rare side effect of bortezomib and its clinical course has not been well described in AL amyloidosis patients.
Methods: We conducted an IRB approved retrospective, single institution study of all patients AL amyloidosis treated with a bortezomib-containing regimen from 2015 to 2022 who developed ocular toxicity. We excluded patients participating in a randomized clinical trial to avoid confounders.
Results: In total, we identified 12 patients and 10 required pharmacologic interventions. First line therapy was topical erythromycin ointment in 5 patients, oral doxycycline in 4 patients, and both in one patient. Of the five patients that started on topical therapy, only one patient had a complete resolution. Four of those patients failed treatment and required oral antibiotics. Subsequent therapy was oral amoxicillin-clavulanate in one patient and doxycycline in an additional three patients. For those that received doxycycline as their next line, both required long term (>8 weeks) doxycycline suppressive treatment to prevent additional styes with one patient adding in topical tobramycin-dexamethasone eye drops. For those treated with doxycycline as first line therapy, two patients were subsequently started on erythromycin ointment, one patient required the addition of oral amoxicillin-clavulanate, and one patient had complete resolution. Patients without suppressive therapy, had a shorter median time to resolution of 6.1 weeks as compared to 12.0 weeks.
Conclusions: Bortezomib-related ocular toxicities in amyloidosis can require multimodal therapy for resolution of symptoms.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Shahrier Hossain, Dana-Farber Cancer Institute, Boston, Massachusetts

**Main Body of the Abstract**
**Background:** Bortezomib is a reversible proteasome inhibitor that is a mainstay of treatment of plasma cell disorders, including AL amyloidosis. Ocular toxicity is a rare side effect of bortezomib and its clinical course has not been well described in AL amyloidosis patients.
**Methods:** We conducted an IRB approved retrospective, single institution study of all patients AL amyloidosis treated with a bortezomib-containing regimen from 2015 to 2022 who developed ocular toxicity. We excluded patients participating in a randomized clinical trial to avoid confounders.
**Results:** In total, we identified 12 patients and 10 required pharmacologic interventions. First line therapy was topical erythromycin ointment in 5 patients, oral doxycycline in 4 patients, and both in one patient. Of the five patients that started on topical therapy, only one patient had a complete resolution. Four of those patients failed treatment and required oral antibiotics. Subsequent therapy was oral amoxicillin-clavulanate in one patient and doxycycline in an additional three patients. For those that received doxycycline as their next line, both required long term (>8 weeks) doxycycline suppressive treatment to prevent additional styes with one patient adding in topical tobramycin-dexamethasone eye drops. For those treated with doxycycline as first line therapy, two patients were subsequently started on erythromycin ointment, one patient required the addition of oral amoxicillin-clavulanate, and one patient had complete resolution. Patients without suppressive therapy, had a shorter median time to resolution of 6.1 weeks as compared to 12.0 weeks.
**Conclusions:** Bortezomib-related ocular toxicities in amyloidosis can require multimodal therapy for resolution of symptoms.



Bortezomib Induced Ocular Toxicities in AL Amyloidosis PC49 (#521)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.