Table 1.
Clinical characteristics and organ response outcomes of patients with AL amyloidosis in hemCR according to MRD status
| Characteristic | MRD negative (n = 29) | MRD positive (n = 36) | P |
|---|---|---|---|
| Characteristics at diagnosis | |||
| Median age (range), y | 60 (32-76) | 61 (30-74) | .73 |
| Female sex, n (%) | 14 (48) | 10 (28) | .12 |
| Light chain type, λ/κ | 24/5 | 29/7 | 1.0 |
| Median dFLC, median (range), mg/L | 129 (34-3120) | 70 (6-462) | .02 |
| Bone marrow PC, median (range), % | 10% (3-30) | 10% (1-25) | .99 |
| Presence of t(11;14), n/N (%) | 6/15 (40) | 8/21 (38) | 1.0 |
| Proteinuria, median (range), g/24 h | 7.8 (0-14.9) | 7.3 (0-32.1) | .49 |
| Serum creatinine, median (range), mg/dL | 0.9 (0.6-4.4) | 1.0 (0.4-3.0) | .53 |
| Serum albumin, median (range), g/dL | 3.2 (1.3-4.6) | 2.9 (1.7-4.7) | .67 |
| BNP, median (range), pg/mL | 155 (10-656) | 128 (11-1792) | .57 |
| BU cardiac stage 1/2/3, n | 10/12/7 | 15/16/5 | .56 |
| Alkaline phosphatase, median (range), IU/L | 86 (17-1027) | 100 (36-1197) | .37 |
| Organ involvement, n (%) | |||
| Kidney | 24 (83) | 28 (78) | .76 |
| Heart | 12 (41) | 17 (47) | .80 |
| Liver | 3 (10) | 7 (19) | .49 |
| PNS | 5 (17) | 4 (11) | .50 |
| ANS | 6 (21) | 8 (22) | 1.0 |
| Final treatments used to achieve hemCR | |||
| HDM/SCT, n (%) | 15 (52) | 17 (47) | .80 |
| Melphalan 140 mg/m2, n | 4 | 6 | |
| Melphalan 200 mg/m2, n | 11 | 11 | |
| Bortezomib-based, n (%) | 6 (21) | 10 (28) | .57 |
| Anti-CD38 monoclonal antibody, n (%) | 8 (28) | 6 (17) | .37 |
| IMiD,* n (%) | 0 (0) | 3 (8) | .25 |
| No. requiring >1 treatment regimen to achieve hemCR, n (%) | 11 (38) | 13 (36) | 1.0 |
| No. with prior HDM/SCT at any time, n (%) | 19 (66) | 27 (75) | .43 |
| Time intervals | |||
| Median no. of mo from diagnosis to hemCR achievement (range) | 8 (1-182) | 5 (2-120) | .78 |
| Median no. of mo from hemCR achievement to MRD testing (range) | 71 (0-238) | 32 (0-260) | .27 |
| Organ responses at MRD assessment, n/N (%) | |||
| Any organ | 26/29 (90) | 27/36 (75) | .20 |
| Renal | 21/24 (88) | 18/28 (64) | .06 |
| Cardiac | 9/12 (75) | 10/17 (59) | .45 |
| Hepatic | 3/3 (100) | 7/7 (100) | 1.0 |
Statistically significant value between the 2 groups is indicated in bold.
ANS, autonomic nervous system; BNP, brain natriuretic peptide; BU, Boston University; IMiDs, immunomodulatory drugs; PNS, peripheral nervous system.
*
Two with lenalidomide and one with pomalidomide.