Table 1 Disease changes and treatment procedures

Feb. 12th 2023

Upper abdominal pain for 17 days

Hb 71 → 45g/L, CT showed retroperitoneal hematoma with no contrast medium leakage

Feb. 13th 2023

Fever and jaundice

Blood transfusion, anti-infection

Feb. 18th 2023

None

CT roughly the same as before

Feb. 25th 2023

Infection state almost controlled

Deventilation and extubation

Feb. 27th 2023

Gastric tube drainage with a intermittent bright red - reddish-brown fluid

Fasting for solids and liquids

Feb. 28th 2023

Same as above

Arrived at the emergency department of PUMCH

Mar. 1st 2023

Low fever, abdominal pain

Admitted to the emergency generalized ward, plasma infusion, anti-infection, cooling, pain relief, rehydration,

Mar. 2nd 2023

Reddish brown of gastric tube drainage

Transferred to EICU and red blood cells, plasma, human fibrinogen, PCCs, vitamin K1 were infused

Mar. 4th 2023

Symptoms were improved

Back to the general ward

Mar. 8th to 24th 2023

Transit to liquid diet without discomfort gradually

Myocardium and abdominal wall biopsy pathology λ + , congo red + , consistent with

amyloidosis (AL-λ type)

Mar. 24th 2023

Same as above

Transferred to the hematology department, developed fever again

Mar. 28th 2023

Same as above

Comprehensive discussion by the professional team

Mar. 29th 2023

Same as above

Daretumab + bortezomib + dexamethasone