A UK consensus algorithm for early treatment modification in newly diagnosed systemic light‐chain amyloidosis

Summary Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1‐month response. In a multivariate model, difference in involved amylo...

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Veröffentlicht in:British journal of haematology Jg. 198; H. 2; S. 328 - 332
Hauptverfasser: Ravichandran, Sriram, Mahmood, Shameem, Wisniowski, Brenden, Sachchithanantham, Sajitha, Popat, Rakesh, Lachmann, Helen, Rabin, Neil, Ramasamy, Karthik, Hawkins, Stephen, Kyriakou, Charalampia, Gillmore, Julian, Yong, Kwee, Hawkins, Philip, Jackson, Graham, Pratt, Guy, D. Wechalekar, Ashutosh
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Blackwell Publishing Ltd 01.07.2022
Schlagworte:
Amyloid
Amyloidogenesis
Amyloidosis
Hematology
Light chains
MGUS
multiple myeloma
Patients
MGUS
multiple myeloma
amyloidosis
ISSN:0007-1048, 1365-2141, 1365-2141
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Abstract Summary Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1‐month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p < 0.005) and no response at 1 month (OR 4.787, p < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response (p < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.
AbstractList Depth of response is the critical determinant of prognosis in amyloid light-chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1-month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p < 0.005) and no response at 1 month (OR 4.787, p < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response (p < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.
Depth of response is the critical determinant of prognosis in amyloid light-chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1-month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p < 0.005) and no response at 1 month (OR 4.787, p < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response (p < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.Depth of response is the critical determinant of prognosis in amyloid light-chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1-month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p < 0.005) and no response at 1 month (OR 4.787, p < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response (p < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.
Summary Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1‐month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p < 0.005) and no response at 1 month (OR 4.787, p < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response (p < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.
Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to improve response based on analysis of baseline characteristics and 1‐month response. In a multivariate model, difference in involved amyloidogenic and uninvolved serum free light chains (dFLC) at diagnosis (dFLC >400 mg/l, odds ratio [OR] 4.051, p  < 0.005) and no response at 1 month (OR 4.787, p  < 0.005) were significant predictors of no improvement in response. Only 5% of patients with a dFLC of >400 mg/l and no response at 1 month improved their response ( p  < 0.005). We suggest that these patients should switch treatment early, subject to their functional status.
Author Lachmann, Helen
Ramasamy, Karthik
Pratt, Guy
Ravichandran, Sriram
Sachchithanantham, Sajitha
Rabin, Neil
Wisniowski, Brenden
Jackson, Graham
D. Wechalekar, Ashutosh
Gillmore, Julian
Popat, Rakesh
Hawkins, Stephen
Mahmood, Shameem
Kyriakou, Charalampia
Yong, Kwee
Hawkins, Philip
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  givenname: Sriram
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  surname: Ravichandran
  fullname: Ravichandran, Sriram
  organization: National Amyloidosis Centre
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  surname: Mahmood
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  organization: University College London Hospitals NHS Foundation Trust
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  organization: University College London Hospitals NHS Foundation Trust
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  surname: Sachchithanantham
  fullname: Sachchithanantham, Sajitha
  organization: Guy's and St Thomas' NHS Foundation Trust
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  surname: Popat
  fullname: Popat, Rakesh
  organization: University College London Hospitals NHS Foundation Trust
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  organization: University College London Hospitals NHS Foundation Trust
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  organization: Oxford University Hospitals NHS Foundation Trust
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  surname: Hawkins
  fullname: Hawkins, Stephen
  organization: Royal Liverpool University Hospital
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  surname: Kyriakou
  fullname: Kyriakou, Charalampia
  organization: University College London Hospitals NHS Foundation Trust
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  surname: Gillmore
  fullname: Gillmore, Julian
  organization: National Amyloidosis Centre
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  surname: Yong
  fullname: Yong, Kwee
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  surname: Hawkins
  fullname: Hawkins, Philip
  organization: National Amyloidosis Centre
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  givenname: Graham
  surname: Jackson
  fullname: Jackson, Graham
  organization: The Newcastle Upon Tyne Hospital NHS Foundation Trust
– sequence: 15
  givenname: Guy
  orcidid: 0000-0002-6937-2852
  surname: Pratt
  fullname: Pratt, Guy
  organization: University Hospital Birmingham NHS Foundation Trust
– sequence: 16
  givenname: Ashutosh
  surname: D. Wechalekar
  fullname: D. Wechalekar, Ashutosh
  email: a.wechalekar@ucl.ac.uk
  organization: University College London Hospitals NHS Foundation Trust
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CitedBy_id crossref_primary_10_3389_frhem_2024_1378451
crossref_primary_10_1080_13506129_2022_2093635
crossref_primary_10_1016_j_ejim_2025_106445
crossref_primary_10_1007_s00277_024_06077_0
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amyloidosis
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Snippet Summary Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely...
Depth of response is the critical determinant of prognosis in amyloid light‐chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to...
Depth of response is the critical determinant of prognosis in amyloid light-chain (AL) amyloidosis. Here, we aim to identify patients who are unlikely to...
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SubjectTerms Amyloid
Amyloidogenesis
Amyloidosis
Hematology
Light chains
MGUS
multiple myeloma
Patients
Title A UK consensus algorithm for early treatment modification in newly diagnosed systemic light‐chain amyloidosis
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