Prognostic Factors ID’d for Stage IIIb AL Amyloidosis

In HealthDay News
by Healthday

Symptom onset to diagnosis longer than six months, bone marrow plasmacytosis ≥10 percent associated with shorter overall survival

By Elana Gotkine HealthDay Reporter

THURSDAY, Aug. 24, 2023 (HealthDay News) — For patients with stage IIIb amyloid light chain (AL) amyloidosis, baseline factors predictive of treatment outcomes and survival have been identified, according to a study published online Aug. 15 in Blood Advances.

Joshua Gustine, from Boston University School of Medicine, and colleagues reported on 142 patients with newly diagnosed stage IIIb AL amyloidosis to examine predictors of early hematologic and cardiac responses, which can prolong survival.

The researchers found that the median overall survival (OS) was nine months after a median follow-up of 60 months. Symptom onset to diagnosis longer than six months, bone marrow plasmacytosis ≥10 percent, troponin I >0.635 ng/mL, New York Heart Association class III/IV, and six-minute walk test distance <200 m were independent baseline factors associated with shorter OS (hazard ratios, 1.94, 1.98, 1.62, 1.67, and 1.85, respectively). Significant associations with longer survival were seen for early hematologic (within one month) and cardiac (within three months) responses. Patients with a hematologic very good partial response, partial response, and no response had median OS of 47, 25, and five months, respectively, in a one-month landmark analysis. Significantly longer OS was seen for patients with cardiac response at three months. Bortezomib use was associated with early hematologic and cardiac responses (odds ratios, 4.54 and 5.11) and longer OS (hazard ratio, 0.43) on multivariable modeling.

“By understanding the significance of early treatment responses at one and three months after beginning treatment, we can better guide our approaches to therapy and improve patient outcomes,” senior study author Vaishali Sanchorawala, M.D., from Boston University, said in a statement.

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