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Prognostic significance of interventricular septal thickness in patients with AL amyloidosis

Authors
 Hyunsoo Cho  ;  Soo-Jeong Kim  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Yu Ri Kim  ;  Woo Ick Yang  ;  Haerim Chung  ;  Ji Eun Jang  ;  June-Won Cheong  ;  Yoo Hong Min  ;  Jin Seok Kim 
Citation
 LEUKEMIA RESEARCH, Vol.60 : 36-43, 2017 
Journal Title
LEUKEMIA RESEARCH
ISSN
 0145-2126 
Issue Date
2017
MeSH
Adult ; Aged ; Amyloidosis/complications ; Amyloidosis/diagnosis ; Amyloidosis/pathology ; Female ; Heart Neoplasms/pathology ; Heart Septum/pathology ; Heart Ventricles/pathology ; Humans ; Immunoglobulin Light Chains ; Immunoglobulin Light-chain Amyloidosis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies
Keywords
AL amyloidosis ; Cardiac involvement ; Interventricular septal thickness ; Prognostic factor
Abstract
The major prognostic determinant of immunoglobulin light chain (AL) amyloidosis is cardiac involvement. However, the role of interventricular septal thickness (IVST), which reflects the extent of cardiac involvement, remains unclear. Therefore, we analyzed 77 patients with newly diagnosed AL amyloidosis and evaluated the prognostic role of IVST. Fifty patients (64.9%) had cardiac involvement and 17 patients (22.1%) showed IVST >15mm. Among all patients, the revised Mayo Clinic Stage III-IV and IVST >15mm were independently associated with inferior overall survival (OS) in a multivariable analysis. IVST >15mm was also adversely prognostic for OS in a subgroup of advanced-stage (revised Mayo Clinic stage III-IV) patients in a multivariable analysis (P<0.001). Furthermore, advanced-stage patients with IVST >15mm did not show survival benefit from treatment with bortezomib-based regimens and/or autologous stem-cell transplantation (ASCT). Our study demonstrated that IVST >15mm is adversely prognostic independent of the revised Mayo Clinic staging system in patients with AL amyloidosis. In addition, the degree of IVST might be used as a useful prognostic indicator that can guide the management of patients with AL amyloidosis especially at an advanced stage.
Full Text
https://www.sciencedirect.com/science/article/pii/S0145212617304617
DOI
10.1016/j.leukres.2017.06.008
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Jang, Ji Eun(장지은) ORCID logo https://orcid.org/0000-0001-8832-1412
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Chung, Hae Rim(정해림) ORCID logo https://orcid.org/0000-0002-7926-9285
Cho, Hyunsoo(조현수) ORCID logo https://orcid.org/0000-0003-2651-6403
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160278
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