 Thank you for this opportunity. My name is Gianparlo Merlini, and I'm the director of Research Institute for the Pinto San Matteo University of Pavia in Pavia, Italy. And I've been working in the field of systemic amelidosis for the last four years. So at age 2020, nearly 40 papers were presented including four oral presentations on amelidosis. These highlights the increasing interest of a dermatologist for this rare disease. In addition to the main papers that we will discuss later, other interesting reports have been presented. Regarding diagnosis, the male click investigators reported a cross-sectional evaluation of light chain reposalation analyzed by mass spectrometry, confirming that patients with amelidosis present a high rate of capillary chain reposalation. This is relevant because we can use this biomarker to follow closely positive patients in order to timely detect the onset of amelidosis and start treatment timely. A poster from the Mayo Clinic analyzing their met needs in amelidosis reported that among 829 newly diagnosed patients seen from 2012 and 2020, 18% presented with very advanced cardiac involvement with very high NTPO BMP above the NTPO BMP. They have a 1,500 nanogram per liter and almost 80% mortality rate at one year. These findings highlight the need to improve early diagnosis and that these patients need specially designed clinical trials and this is indeed an unmet need. The University of Tennessee group reported a possibility to detect light chain amelidosis with the radio labeled synthetic polybasic peptides P5 plus 14 as alternative radio tracers for detecting amelidosis. This peptide may help discriminating between light chain and from staratin amelidosis. Few papers were presented on prognosis. A study from the Eiderberg group reported that the genetic abnormality gain 1q21 is an adverse prognostic factor in patients with relapsed refractory amelidosis treated with linoidomide and exometazone. This study adds further data to the value of cytogenetic analysis by fluorescence in situabilization indirect in therapy. A study from the London group reported that the longitudinal strain obtained by echocardiography is an informative functional marker that is independent of male staging in predicting outcomes in patients with cardiac amelidosis which may be used to monitor response to therapy. One study from the Mayo Clinic reported that having an ejection fraction less than 55% is associated with a higher day 100 treatment related mortality and this is an independent predictor for progression phase survival and overall survival in patients with amelidosis undergoing themselves transplantation regarding therapy. On Monday, another presentation reported the outcome of a phase two study of Isatuximab for patients with previously treated amelidosis. Isatuximab is an IgG1 Kappa monoclonal antibody directed to plasma cell surface antigen CD38. In the 35 evaluable patients, a mythology response was observed in 77% in a median time of only one month. Grade 3, 4 adverse events were rare and safety data were comparable to those seen in Daratumumab monotherapy. Another study from the Mayo Clinic reported the outcomes of a phase two trial of Ixazomib that is an oral proteasome inhibitor like Bortazomib. Combined with cyclophosphamide and exometazone in previously treated patients, the results show that these oral regimen, all these drugs are oral, is active with a mythology response observing 57% of patients including complete responses. Organ response has been observed but we likely need longer follow up for accurate assessment given the delay in organ response in this disease. Part of the evaluation of this combination is warranted. Regarding proteasome inhibitors, the Pavia group in collaboration with the Italian medicine advocacy reported the outcome of the Italian prospective registry of Bortazomib base treatment in Ilamilodosis. 605 patients were included in this analysis but sure that outside referral centers, Bortazomib is mostly used in combination with exometazone alone and that treatment is started in patients in advanced stage again indicating the need for early diagnosis. Obviously COVID-19 had an impact in the care of the disease and the study performed by the Arche Research Collaborative Data Hub on outcomes of patients with hematologic malignancy and COVID-19 infection included 40 patients with myeloma or amylodosis. This study concluded by patients with hematologic malignancies experienced significant morbidity and mortality from COVID-19 infection. However, there is no reason based on the data to withhold intensive therapies from patients with hematologic malignancy and favorable prognosis if aggressive supported care is obviously consistent with patient preferences. In addition, the preliminary outcomes of the ongoing survey of the International Society of Myelodosis on the impact of COVID pandemic on patients with systemic Lycea myelodosis were reported. The fatality rate and the proportion of patients with severe COVID-19 in this series is in the higher range of reports from the general population. Severe SARS-CoV-2 infection can result in renal failure in patient with renal amylodosis. Four posters and another presentation reported the results of the recently concluded Andromeda trial that included 388 untreated patients were randomized to receive CYBOR-D or CYBOR-D plus data tumor map. The posters focused on various aspects health related quality of life outcomes by cardiac stage, the association between rapid and deep hematology responses and improved major organ deterioration, progression phase survival and the similar efficacy in Asian patients. The other presentation focused on hematologic response using diverse criteria. Independent of response criteria, the addition of data to CYBOR-D increased the rate of deep hematologic responses that were associated with prolonged major organ deterioration, progression phase survival and improved cardiac and renal responses with unprecedented 53% rate of complete and rapid responses combined with safe, manageable safety profile. This combination represents a potential new standard of care for renal amylodosis. In a prospective observational multi-center study by the European Myeloma Network analyzed the real-world efficacy outcomes for patients with systemic renal amylodosis throughout Europe. This study aims to enroll approximately 4,000 patients from 13 sites in 10 countries across Europe. Patients must have received first-line therapy between 2004 and 2018. So far, 2,787 patients from nine countries have been enrolled. Patients were divided in two cohorts from 2004 to 2010 and from 2011 to 2018. The similar proportion of stage 3 patients approximately 15% in the two cohorts indicates that the renal amylodosis is still in unmet need. Stage 3 patients are patients who present with very high NTPoBMP value above 8,500, as I refer to usually regarding the male clinic studies. And these patients present an extremely poor outcome because we are diagnosed too late when the damage to the heart is very advanced. So it's very important to prevent this situation, making early diagnosis. So the portatumibase regimens have been the prevailing first-line treatment after 2010, regardless cardiac stage, whereas imid, that means renal domi or pomalidomide-based treatment were the standard second-line therapy for one third of the patients. Complete responses rates remain unsatisfactory despite improvement with portatumibase regimens. These regimens, based on portatumibase, drive the trend of improved survival observed in recent years, except for stage 3B patients. The survival for this patient group is very dismal even nowadays. Substantial health care, resource utilization, for hospitalization or dialysis was observed during the course of the disease. Importantly, early mortality for high-risk patients stage 3B remains substantial and does not improve and remains in a met need. So the main message is improve the diagnostic capability in order to really benefit these patients and reduce as much as possible the number of patients who present with very advanced cardiac involvement in stage 3B. Another presentation focused on safety, durability and efficacy of CHIL 101 in alamylidosis patients treated on a phase 2 open label dose selection study to evaluate the safety and tolerability of these agents in patients with alamylidosis. CHIL 101 is a chimeric immunodobulin IgG1 Kappa very apt, specifically with light chain fibers irrespective of their Kappa-Orlanda esotype but notably not with the native Kappa-Orlanda circulating light chains. The study involved 15 patients CHIL 101 was shown to be safe and well-tolerated in combination with CYBORD with 1.5 milligram per square meter as established as a commanded phase 3 dose for the ongoing phase 3 trials in this disease. The main, the most common and important investments were rash, diarrhea, nausea and vomiting and inner responses were observed in all 7 patients with kidney involvement while only one of the 8 patients with cardiac involvement responded with no data on hematologic response were provided. Importantly, 2 phase 3 studies comparing CYBORD D-CYBORD D plus CHIL 101 are ongoing in patients with advanced cardiac involvement in stage 3A. 3A means advanced cardiac involvement but without anti-probium P very high or stage 3B which is the stage that includes patients with very high anti-probium P and so present very advanced cardiac involvement and very poor outlook. So this trial is very important because it will really tell us if this approach can really rescue organ dysfunction even in patients with very advanced organ damage. The unprecedented results obtained with Daratumumab and CYBORD D that I presented before in frontline therapy opens the door for the approval of Daratumumab. Actually, Daratumumab has been already already approved in Brazil and approval by FDA and EMA is expected shortly. So this will represent the first drug ever approved for this air disease and we all hope that this will be the first of several drugs to follow but very importantly we believe that in the next weeks we will see the approval of this drug throughout Europe and the space. So the present preferred treatment are both stage 3B base and according to the strong evidence provided by the Andromeda study the current standard of care will be CYBORD D plus Daratumumab. So this is currently the standard of care. However, several recent reports indicate that the neto plaques that is a drug that inhibits BCl2 causing the apoptosis, the death of the tumor cells is extremely active in patients with transvocation in 1114 which is present in more than 50% of patients with fibromelidosis. So this will be really a target drug. Furthermore, as reported above other monoclonal antibodies directed to plasma cell scientists such as the anti-CD38 is a tuximab or Berantamab Maffodontin that is an immunoconjugate targeting B cell maturation antigen PCMA are now in clinical trials. Anti-amyloid antibodies are also entering in phase 3 trials and they may contribute to accelerate organ recovery. As we learn to better control the cytokine storm of CAR-T cell therapy this approach may also be considered for lichenomyelidosis. Although we have a promising pipeline of new medicines we must still invest in improving awareness in order to facilitate the recognition of this disease and to offer effective therapies to all patients.