# Clinical characteristics and prognosis of immunoglobulin light chain amyloidosis patients

## TL;DR

This study identifies key factors that predict survival in patients with immunoglobulin light chain amyloidosis to improve risk assessment and treatment planning.

## Contribution

The study introduces a risk stratification model using clinical factors to guide patient management in AL amyloidosis.

## Key findings

- Higher bone marrow plasma cell count and myeloma presence were strongly linked to worse survival outcomes.
- Heart failure and elevated fibrinogen degradation products also significantly predicted poor survival.
- Multivariable analysis confirmed these factors as independent risk indicators for death.

## Abstract

To analyze the prognostic factors associated with overall survival (OS) in patients diagnosed with immunoglobulin light chain (AL) amyloidosis, with the goal of improving risk stratification and patient management.

A retrospective cohort analysis was conducted on 87 patients diagnosed with AL amyloidosis at the People’s Hospital of Ningxia Hui Autonomous Region from January 2016 to December 2023. Demographic, clinical, laboratory data, and survival status were collected. Univariable and multivariable Cox regression analyses were used to identify significant predictors of OS. Kaplan–Meier survival curves and restricted cubic spline (RCS) analysis were employed to evaluate risk stratification.

The median overall survival was 22.0 months (95% CI: 15.2–28.8), and the median follow-up duration was 39.0 months (95% CI: 29.2–48.8). Our results revealed that higher bone marrow plasma cell count (BMPCs), myeloma presence, heart failure, and increased fibrinogen degradation products (FDP) were significantly associated with poor survival outcomes. The median survival time for patients with BMPCs >12% was 13 months, compared to 36 months for those with lower BMPCs. Myeloma presence was the strongest predictor of survival, with a median survival of 15 months for those with myeloma versus 36 months for those without. Multivariable analysis identified that myeloma (HR = 2.582, 95% CI: 1.105–6.034, p = 0.029), heart failure (HR = 2.258, 95% CI: 1.098–4.641, p = 0.027), higher BMPCs (HR = 1.018, 95% CI: 1.001–1.035, p = 0.035), and elevated FDP levels (HR = 1.018, 95% CI: 1.004–1.017, p = 0.001) were independent risk factors for death.

Elevated BMPCs, concurrent myeloma, heart failure, and increased FDP levels were associated with poor OS of AL amyloidosis patients. These factors could be incorporated into clinical decision-making to better stratify risk and guide treatment strategies for AL amyloidosis patients.