Table 1
Cardiovascular risk factors for increased light chain amyloidosis mortality.36,37,38,39,40,41,42,43,44,45,46,47,48 OS: overall survival; MRI: magnetic resonance imaging; EF: ejection fraction
| FINDING | RISK FACTOR | NOTES |
|---|---|---|
| Arrhythmias | Atrial fibrillation | Inferior short-term OS but no impact on peritransplant mortality36,37 |
| Nonsustained ventricular tachycardia | Inferior short-term OS but no impact on peritransplant mortality36 | |
| Ventricular tachycardia | Increased mortality37 | |
| Cardiac MRI Findings | Left atrial EF < 16% | Higher risk of 2-year mortality41 |
| Long axis strain > –7% | Higher risk of death and cardiac transplantation42 | |
| Myocardial contraction fraction < 52.6% | Higher risk of death and cardiac transplantation42 | |
| Right ventricular dysfunction | Predicts all-cause mortality43 | |
| New York Heart Association functional class 3/4 | Increased mortality44 | |
| Clinical Findings | Left heart valve thickening > 3 mm | Higher all-cause mortality45 |
| Echocardiographic Findings | Interventricular septal thickness > 15 mm | Inferior OS46 |
| Relative wall thickness > 0.74 | Increased mortality44 | |
| Right atrial volume index > 35 and other signs of right ventricular dysfunction | High 1-year mortality37 | |
| Global longitudinal strain (GLS) < 17% | 5-year survival of 47% vs 95% if GLS > 17%38,39,40 | |
| Electrocardiographic Findings | Abnormal QRS axis | Poorer survival47 |
| Frontal QRS-T angle > 102 | Increased mortality48 | |
| QTc > 483 msec | Poorer survival47 |
Table 2
Overall survival (OS) of light chain amyloidosis patients by stage at diagnosis and time from treatment initiation. Group 1: 2015 European modification of Mayo 2004 staging; Group 2: Mayo 2012 staging; NR: not reached; N/A: not assessed
| GROUP 1 STAGE (1,357 PTS) | MEDIAN OS AT DIAGNOSIS (YRS) | MEDIAN OS AT 3 MO (YRS) | MEDIAN OS AT 6 MO (YRS) |
|---|---|---|---|
| I | 12 | 11.8 | NR |
| II | 5.4 | 10.8 | NR |
| IIIA | 1.8 | 4.6 | 5.4 |
| IIIB | 0.4 | 1.1 | 0.9 |
| GROUP 2 STAGE (1,339 PTS) | |||
| I | 11.4 | 11.8 | NR |
| II | 8.2 | 9.0 | NR |
| III | 2.4 | 5.2 | 4.6 |
| IV | 0.5 | 0.8 | 0.9 |