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Despite substantial therapeutic advances, delayed diagnosis remains common because of nonspecific presentations and the need for coordinated hematologic, pathologic, and organ\u2010specific evaluation. The introduction of daratumumab\u2010based regimens has transformed frontline therapy, whereas advances in cytogenetic profiling, measurable residual disease assessment, and transplantation strategies have informed risk\u2010adapted management. Emerging treatments, including BCL\u20102\u2013targeted therapy, bispecific antibodies, chimeric antigen receptor T\u2010cell therapy, and possibly fibril\u2010directed approaches, further expand the therapeutic landscape. This review summarizes contemporary concepts in the pathobiology, diagnosis, and management of systemic light\u2010chain amyloidosis, with an emphasis on practical diagnostic algorithms, evolving response assessment, and remaining challenges in achieving durable organ recovery and sustained survival.<\/jats:p>","DOI":"10.3322\/caac.70092","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:25:48Z","timestamp":1780939548000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic amyloid light\u2010chain amyloidosis beyond ANDROMEDA: Diagnostic challenges and therapeutic updates"],"prefix":"10.3322","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1879-1248","authenticated-orcid":false,"given":"Xia","family":"Wu","sequence":"first","affiliation":[{"name":"Tufts Medicine Myeloma and Amyloid Program Tufts Medical Center  Boston Massachusetts 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