Abstract
Organ recovery following anti-plasma cell therapy is associated with improved outcome in patients with AL amyloidosis. Current organ response criteria do not consider the depth of response. Newly diagnosed AL amyloidosis patients who had involvement of at least one evaluable organ and documentation of organ response were included. Cardiac response was seen in 182 patients. Time to cardiac response was 9.4 months. Renal response was seen in 278 patients, at a median time to response of 6 months. Hepatic response was seen in 70 patients, with a median time to response of 6.1 months. In all organs, the deeper the organ response achieved, the longer the survival. This led to four organ response criteria: complete organ response (nadir NT-proBNP ≤400 pg/mL; nadir proteinuria ≤200 mg per 24 h; nadir alkaline phosphatase ≤×2 lower limit of normal); very good partial organ response (>60% reduction in parameter not meeting complete organ response definition); partial organ response (31–60% reduction in parameter); and non-responder (≤30% reduction in organ response parameter). Cardiac and renal progression were associated with baseline organ impairment and inversely associated with the depth of organ response. Grading the depth of organ response provides additional valuable prognostic information for newly diagnosed AL amyloidosis patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | Leukemia |
| DOIs | |
| State | Accepted/In press - Feb 20 2018 |
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ASJC Scopus subject areas
- Hematology
- Cancer Research
- Anesthesiology and Pain Medicine
Cite this
Depth of organ response in AL amyloidosis is associated with improved survival : grading the organ response criteria. / Muchtar, Eli; Dispenzieri, Angela; Leung, Nelson; Lacy, Martha; Buadi, Francis K.; Dingli, David M; Grogan, Martha; Hayman, Suzanne R.; Kapoor, Prashant; Hwa, Yi Lisa; Fonder, Amie; Hobbs, Miriam; Chakraborty, Rajshekhar; Gonsalves, Wilson; Kourelis, Taxiarchis; Warsame, Rahma; Russell, Stephen J; Lust, John A.; Lin, Yi; Go, Ronald S.; Zeldenrust, Steven; Kyle, Robert A.; Rajkumar, S Vincent; Kumar, Shaji K; Gertz, Morie.
In: Leukemia, 20.02.2018, p. 1-10.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Depth of organ response in AL amyloidosis is associated with improved survival
T2 - grading the organ response criteria
AU - Muchtar, Eli
AU - Dispenzieri, Angela
AU - Leung, Nelson
AU - Lacy, Martha
AU - Buadi, Francis K.
AU - Dingli, David M
AU - Grogan, Martha
AU - Hayman, Suzanne R.
AU - Kapoor, Prashant
AU - Hwa, Yi Lisa
AU - Fonder, Amie
AU - Hobbs, Miriam
AU - Chakraborty, Rajshekhar
AU - Gonsalves, Wilson
AU - Kourelis, Taxiarchis
AU - Warsame, Rahma
AU - Russell, Stephen J
AU - Lust, John A.
AU - Lin, Yi
AU - Go, Ronald S.
AU - Zeldenrust, Steven
AU - Kyle, Robert A.
AU - Rajkumar, S Vincent
AU - Kumar, Shaji K
AU - Gertz, Morie
PY - 2018/2/20
Y1 - 2018/2/20
N2 - Organ recovery following anti-plasma cell therapy is associated with improved outcome in patients with AL amyloidosis. Current organ response criteria do not consider the depth of response. Newly diagnosed AL amyloidosis patients who had involvement of at least one evaluable organ and documentation of organ response were included. Cardiac response was seen in 182 patients. Time to cardiac response was 9.4 months. Renal response was seen in 278 patients, at a median time to response of 6 months. Hepatic response was seen in 70 patients, with a median time to response of 6.1 months. In all organs, the deeper the organ response achieved, the longer the survival. This led to four organ response criteria: complete organ response (nadir NT-proBNP ≤400 pg/mL; nadir proteinuria ≤200 mg per 24 h; nadir alkaline phosphatase ≤×2 lower limit of normal); very good partial organ response (>60% reduction in parameter not meeting complete organ response definition); partial organ response (31–60% reduction in parameter); and non-responder (≤30% reduction in organ response parameter). Cardiac and renal progression were associated with baseline organ impairment and inversely associated with the depth of organ response. Grading the depth of organ response provides additional valuable prognostic information for newly diagnosed AL amyloidosis patients.
AB - Organ recovery following anti-plasma cell therapy is associated with improved outcome in patients with AL amyloidosis. Current organ response criteria do not consider the depth of response. Newly diagnosed AL amyloidosis patients who had involvement of at least one evaluable organ and documentation of organ response were included. Cardiac response was seen in 182 patients. Time to cardiac response was 9.4 months. Renal response was seen in 278 patients, at a median time to response of 6 months. Hepatic response was seen in 70 patients, with a median time to response of 6.1 months. In all organs, the deeper the organ response achieved, the longer the survival. This led to four organ response criteria: complete organ response (nadir NT-proBNP ≤400 pg/mL; nadir proteinuria ≤200 mg per 24 h; nadir alkaline phosphatase ≤×2 lower limit of normal); very good partial organ response (>60% reduction in parameter not meeting complete organ response definition); partial organ response (31–60% reduction in parameter); and non-responder (≤30% reduction in organ response parameter). Cardiac and renal progression were associated with baseline organ impairment and inversely associated with the depth of organ response. Grading the depth of organ response provides additional valuable prognostic information for newly diagnosed AL amyloidosis patients.
UR - http://www.scopus.com/inward/record.url?scp=85044444480&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044444480&partnerID=8YFLogxK
U2 - 10.1038/s41375-018-0060-x
DO - 10.1038/s41375-018-0060-x
M3 - Article
C2 - 29581546
AN - SCOPUS:85044444480
SP - 1
EP - 10
JO - Leukemia
JF - Leukemia
SN - 0887-6924
ER -