Plasma cell proliferative index predicts outcome in immunoglobulin light chain amyloidosis treated with stem cell transplantation

M. Hasib Sidiqi, Mohammed A. Aljama, Dragan Jevremovic, William G. Morice, Michael Timm, Francis K. Buadi, Rahma Warsame, Martha Q. Lacy, Angela Dispenzieri, David Dingli, Wilson I. Gonsalves, Shaji Kumar, Prashant Kapoor, Taxiarchis Kourelis, Nelson Leung, William J. Hogan, Morie Gertz

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

The plasma cell proliferative index provides an insight into plasma cell biology in plasma cell disorders and is an important prognostic marker in myeloma and smoldering myeloma. We analyzed the prognostic impact of the plasma cell proliferative index in 513 patients with systemic immunoglobulin light chain (AL) amyloidosis undergoing stem cell transplantation at the Mayo Clinic between 1 st January 2003 and 31 st August 2016. Two cohorts were identified according to Low or Elevated plasma cell proliferative index. Patients with an Elevated plasma cell proliferative index had more cardiac involvement (56% vs. 44%; P=0.01), less renal involvement (55% vs. 70%; P=0.001), and were more likely to have 10% or over bone marrow plasma cells (58% vs. 32%; P<0.0001) compared to those with a Low plasma cell proliferative index. Both progression-free survival and overall survival were lower in patients with an Elevated compared to Low plasma cell proliferative index: median progression-free survival 44 vs. 95 months (P<0.0001) and median overall survival 102 vs. 143 months (P=0.0003). All-cause mortality at 100 days was higher in patients with an Elevated plasma cell proliferative index (elevated 10.3% vs. low 4.3%; P=0.008). On multivariate analysis Elevated plasma cell proliferative index was an independent prognostic factor for overall survival (Hazard Ratio 1.5, 95%CI: 1.1-2.1; P=0.021). The plasma cell proliferative index is an important prognostic tool in patients with AL amyloidosis undergoing stem cell transplant.

Original languageEnglish (US)
Pages (from-to)1229-1234
Number of pages6
JournalHaematologica
Volume103
Issue number7
DOIs
StatePublished - Jul 3 2018

ASJC Scopus subject areas

  • Hematology

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