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

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. Green open access

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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.

Type: Article
Title: A UK consensus algorithm for early treatment modification in newly diagnosed systemic light-chain amyloidosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjh.18216
Publisher version: https://doi.org/10.1111/bjh.18216
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: MGUS, amyloidosis, multiple myeloma
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10150616
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