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M.H. Sidiqi et al.
We review the prognostic impact of the plasma cell pro- liferative index in a large cohort of patients with AL amy- loidosis undergoing stem cell transplant at the Mayo Clinic, and assess patients’ and disease characteristics as well as the prognostic impact of PCPI on outcome and sur- vival.
Methods
After approval by the Mayo Clinic Institutional Review Board, data were reviewed on all patients with biopsy proven systemic AL amyloidosis who underwent autologous stem cell transplant between 1st January 2003 and 31st August 2016 and had a plasma
Table 1. Patients' baseline characteristics. Characteristic
Age, years, median (IQR) Male%
Organs involved, n (%)
Cardiac Renal Hepatic Neurological Other
Organs involved, n (%) 1
2
Lambda
Kappa
Pre-ASCT light chain mg/dL, median (IQR) Bone marrow plasma cells, n (%)
<10%
I
II
III Missing
Mayo Stage 2012, n (%) I
II III IV
Missing Conditioning, n (%)
Melphalan 200 mg/m2
Melphalan <200 mg/m2 Pre-ASCT chemotherapy n (%)
Untreated Corticosteroid only Melphalan based IMID based Bortezomib based Other
Time Period of Transplant, n (%) < 2010
≥ 2010
Low PCPI (n=348) Elevated PCPI (n=165) P
59 (53-65) 58 (52-63) 0.26 64 63 0.77
153 (44) 243 (70) 35 (10) 49 (14) 76 (22)
164 (47) 124 (36) 60 (17)
258 (74) 90 (26) 12.4 (5.8-34.4)
236 (68)
112 (32)
1 (0.9-1.3) 3.3 (0.2-7.0) 417 (150-1757) 13 (4%) 0.01 (0.01-0.02)
200 (68) 46 (16) 48 (16) 54
139 (48) 79 (27) 45 (16) 26 (9) 59
256 (74) 89 (26)
221 (64) 35 (10) 14 (4) 19 (5) 48 (14) 11 (3)
207 (59)
141 (41)
93 (56) 0.01
90 (55)
19 (11) 0.65 25 (15) 0.79 52 (31) 0.02
≥3
Light chain, n (%)
62 (37) 69 (42) 34 (21)
118 (72) 47 (28) 20.8 (8.7-56.3)
70 (42)
0.12
0.52
0.0004 <0.0001
0.001
≥10%
Creatinine, median, mg/dL
Urine 24-hour protein, median, g NT-Pro BNP, median, pg/mL (IQR) NT-Pro BNP >8500, n (%) Troponin T, median, ng/mL (IQR) Mayo Stage 2004, n (%)
95 (58)
1 (0.9-1.2) 0.88
0.98 (0.2-6.1)
901 (197-2499) 0.02
3 (2%) 0.28 0.01 (0.01-0.03) 0.13 0.38
0.049
91 (61) 29 (20) 28 (19) 17
51 (35) 54 (37) 22 (15) 20 (13) 18
104 (63) 60 (37)
78 (47) 19 (12) 15 (9) 16 (10) 35 (21) 2 (1)
93 (56)
72 (44)
0.03
0.02
0.0023 0.0006
0.5
1230
ASCT,: autologous stem cell transplant; PCPI: plasma cell proliferation index; IMiD: immunomodulatory drug; IQR: interquartile range; n: number.
haematologica | 2018; 103(7)