Ravichandran, Sriram;
Mahmood, Shameem;
Wisniowski, Brenden;
Sachchithanantham, Sajitha;
Popat, Rakesh;
Lachmann, Helen;
Rabin, Neil;
... D Wechalekar, Ashutosh; + view all
(2022)
A UK consensus algorithm for early treatment modification in newly diagnosed systemic light-chain amyloidosis.
British Journal of Haematology
, 198
(2)
pp. 328-332.
10.1111/bjh.18216.
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Abstract
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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