Researchers create new accessible staging system to predict survival for patients with AL amyloidosis

A new staging system developed with a more accessible test to predict the chance of survival in patients living with light chain (AL) amyloidosis. Led by researchers from the Amyloidosis Center at Boston Medical Center (BMC) and Boston University School of Medicine, the test incorporates cardiac biomarkers to accurately identify the involvement of the heart in the disease, allowing doctors to predict outcomes of patients with AL amyloidosis.

AL Amyloidosis is a rare condition caused when bone marrow produces abnormal antibodies that can't be broken down and are deposited in tissues, interfering with organ function. Survival for patients with AL amyloidosis is related to cardiac involvement, making cardiac biomarkers an accurate measure for staging for risk stratification.

BMC researchers created the new brain natriuretic peptide (BNP)-based staging to align with current staging systems that use another test, called N-terminal pro-brain natriuretic peptide (NT-proBNP). The NT-proBNP testing method is not available at all medical centers; however, BNP testing is available at these academic facilities, making the new Boston University (BU) biomarker score a viable option for hospitals seeing patients with AL Amyloidosis.

The researchers analyzed data from 250 participants who had received both tests during their evaluation at the Amyloidosis Center between April 2016 and September 2016. The study, published in Blood, Journal of the American Society of Hematology, found that the BU biomarker system accurately identified cardiac involvement and separated patients into survival stages equivalent with current systems.

"Our goal in creating the BU biomarker score and staging system was to increase access to appropriate staging systems at hospitals that are not able to perform NT-proBNP testing," said Vaishali Sanchorawala, MD, senior author and director of the Amyloidosis Center at BMC and BUSM. "Despite being a rare disease, it is vital that all patients with AL amyloidosis are given the best chance at effective treatment and ultimately, survival."

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