Decrease of B-type natriuretic peptide to less than 200 pg/mL predicts longer survival in cardiac immunoglobulin...

Area of Science:

• Hematology
• Cardiology
• Oncology

Background:

• Immunoglobulin light chain (AL) amyloidosis results from abnormal plasma cells producing amyloid fibrils.
• This systemic disorder has a poor prognosis, with a median survival time (MST) of 1-2 years, and only 6 months for patients with cardiac involvement.

Purpose of the Study:

• To evaluate treatment outcomes for AL amyloidosis patients, focusing on cardiac involvement.
• To determine if B-type natriuretic peptide (BNP) levels predict survival in cardiac AL amyloidosis.

Main Methods:

• Retrospective analysis of 24 AL amyloidosis patients treated between January 2008 and December 2012.
• Comparison of survival rates based on cardiac involvement and post-treatment BNP levels (<200 pg/mL).

Main Results:

• Patients with cardiac involvement had a significantly shorter MST (9.8 months).
• Achieving a post-treatment BNP <200 pg/mL was associated with significantly longer survival (MST not reached vs. 6.1 months).
• The median time to reach a BNP <200 pg/mL was 6.3 months.

Conclusions:

• Cardiac involvement is a negative prognostic factor in AL amyloidosis.
• A decline in BNP to <200 pg/mL during treatment is a strong predictor of improved survival in patients with cardiac AL amyloidosis.