Outcomes of patients with AL amyloidosis and low serum free light chain levels at diagnosis

Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis
Vina P NguyenV Sanchorawala

Abstract

Serum free light chains (sFLC) are independent prognostic markers of disease in light chain (AL) amyloidosis, and are used in the haematologic response criteria for treatment. However, up to 20% of patients have low sFLCs at diagnosis, with a difference between involved and uninvolved free light chains (dFLC) of less than 50 mg/L, making responses to treatment difficult to evaluate. In order to characterize this distinct subgroup of patients, we retrospectively analyzed 123 AL amyloidosis patients with dFLC <50 mg/L who were diagnosed between 2002 and 2013. The majority (n = 117) were treated for their AL amyloidosis, with over half (n = 68) receiving high-dose melphalan and autologous stem cell transplantation as first-line therapy. Overall they had a prolonged median survival of 9.2 years with less cardiac involvement (30%) and more renal involvement (76%). We also evaluated the newly proposed low dFLC partial response (PR) criteria, defined as a dFLC <10 mg/L if the initial dFLC 20-50 mg/L. The 14 patients with low dFLC PR had improved survival and organ responses compared with patients with no haematologic response. However, one-third of patients (n = 41) had an initial dFLC <20 mg/L so could not be evaluated. More sensitiv...Continue Reading

References

Jan 10, 2006·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Harun AkarMartha Skinner
Feb 22, 2008·Haematologica·Tilmann BochtlerStefan O Schonland
Mar 28, 2008·Blood·Angela DispenzieriPhilip R Greipp
Feb 15, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Shaji KumarMorie A Gertz
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Apr 26, 2017·American Journal of Hematology·Paolo MilaniAngela Dispenzieri

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Citations

Jun 8, 2021·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Victor H Jimenez-ZepedaNizar Bahlis
Jun 23, 2020·Acta Haematologica·Tobias DittrichStefan O Schönland

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