Affiliation:
1. Amyloidosis Center Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts USA
2. Section of Hematology and Medical Oncology Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center Boston Massachusetts USA
Abstract
SummaryPatients with AL amyloidosis can have persistent organ dysfunction despite achieving a haematological complete response (hemCR). We aimed to identify factors for organ non‐response among 143 patients who achieved hemCR for ≥6 months. Kidney, heart and liver non‐response were observed in 40/117 (34%), 19/68 (28%) and 3/17 (18%) patients respectively. Predisposing factors varied by organ system. Kidney non‐responders had more advanced organ dysfunction at diagnosis, whereas heart non‐responders had disproportionately more lambda‐typic amyloidogenic light chains. Most patients without an apparent reason for organ non‐response had detectable residual clonal disease. The interplay of factors impeding organ recovery in AL amyloidosis is complex.