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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Published in:British journal of haematology Vol. 198; no. 2; pp. 328 - 332
Main Authors: 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
Language:English
Published: England Blackwell Publishing Ltd 01.07.2022
Subjects:
Amyloid
Amyloidogenesis
Amyloidosis
Hematology
Light chains
MGUS
multiple myeloma
Patients
MGUS
multiple myeloma
amyloidosis
ISSN:0007-1048, 1365-2141, 1365-2141
Online Access:Get full text
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Summary: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.
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ISSN:0007-1048
1365-2141
1365-2141
DOI:10.1111/bjh.18216