Int J Med Sci 2022; 19(3):588-595. doi:10.7150/ijms.61712 This issue Cite

Research Paper

Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study

Junhui Xu1,2†, Zhixiang Qiu1, Miao Yan1, Bingjie Wang1, Zhengyang Song1, Huihui Liu1, Mangju Wang1✉, Xinan Cen1✉

1. Department of Hematology, Peking University First Hospital, Beijing, China
2. Department of Cardiology, Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
This is the first author of this study.

Citation:
Xu J, Qiu Z, Yan M, Wang B, Song Z, Liu H, Wang M, Cen X. Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study. Int J Med Sci 2022; 19(3):588-595. doi:10.7150/ijms.61712. https://www.medsci.org/v19p0588.htm
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Abstract

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Background: Patients with amyloid light-chain (AL) amyloidosis with a bone marrow plasma cell ratio > 10% (AL-PCMM) have a poorer prognosis than patients with AL amyloidosis with a bone marrow plasma cell ratio of <10% (AL-only), similar to that of patients with AL amyloidosis and multiple myeloma (AL-MM). However, the prognostic factors for AL-PCMM and AL-MM have not been studied.

Methods: A total of 49 patients with AL-PCMM or AL-MM in the Peking University First Hospital registry in 2010-2018 were enrolled. Clinical and follow-up data were collected. The relationship between clinical parameters and survival time was also assessed.

Results: Compared with patients with AL-PCMM, patients with AL-MM only had a higher incidence of bone marrow plasma cell ratio ≥ 20%. In AL-PCMM and AL-MM, the survival time was significantly shorter in patients with alkaline phosphatase (ALP) ≥ 187.5 IU/L, γ-glutamyl transpeptidase (GGT) ≥ 85 IU/L, total bilirubin (TBIL) ≥ 20 µmol/L, cardiac troponin I (CTNI) ≥ 0.1 ng/mL, ejection fraction (EF) < 50%, initial therapeutic effect (ITE) < very good partial response (VGPR), and Boston University (BU) staging system stage ≥ III. ALP at diagnosis was correlated with brain natriuretic peptide (BNP) level, CTNI level, and EF rather than TBIL level. Cox regression analyses revealed that BU staging system stage ≥ III (P=0.001, hazard ratio [HR]=5.579), ALP ≥ 187.5 IU/L (P=0.011, HR=3.563), and ITE < VGPR (P=0.002, HR=7.462) were independent significant risk factors for a poor prognosis of AL-PCMM and AL-MM.

Conclusion: ALP level, which is related to cardiac amyloidosis rather than liver involvement, can be a prognostic factor for this group of patients. A BU staging system stage ≥ III, ALP ≥ 187.5 IU/L, and ITE < VGPR were independent significant risk factors for a poor prognosis of AL-PCMM and AL-MM.

Keywords: AL amyloidosis, AL-PCMM, AL-MM, prognostic factors, BU staging system


Citation styles

APA
Xu, J., Qiu, Z., Yan, M., Wang, B., Song, Z., Liu, H., Wang, M., Cen, X. (2022). Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study. International Journal of Medical Sciences, 19(3), 588-595. https://doi.org/10.7150/ijms.61712.

ACS
Xu, J.; Qiu, Z.; Yan, M.; Wang, B.; Song, Z.; Liu, H.; Wang, M.; Cen, X. Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study. Int. J. Med. Sci. 2022, 19 (3), 588-595. DOI: 10.7150/ijms.61712.

NLM
Xu J, Qiu Z, Yan M, Wang B, Song Z, Liu H, Wang M, Cen X. Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study. Int J Med Sci 2022; 19(3):588-595. doi:10.7150/ijms.61712. https://www.medsci.org/v19p0588.htm

CSE
Xu J, Qiu Z, Yan M, Wang B, Song Z, Liu H, Wang M, Cen X. 2022. Prognostic Factors of AL-PCMM and AL-MM: A Single-Center Retrospective Study. Int J Med Sci. 19(3):588-595.

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