• Colomb Medica · Jul 2023

    Clinical characterization and outcomes of a cohort of colombian patients with AL Amyloidosis.

    • Jorge Andrés Lacouture Fierro, Daniel Andrés Ribero Vargas, Juanita Sánchez Cano, Lina Maria Gaviria Jaramillo, Oliver Gerardo Perilla Suarez, Kenny Mauricio Galvez Cárdenas, and Sigifredo Ospina Ospina.
    • Hospital San Vicente Fundación Rionegro , Departamento de Hematología, Rionegro, Colombia.
    • Colomb Medica. 2023 Jul 1; 54 (3): e2025667e2025667.

    BackgroundAmyloid light chain (AL) amyloidosis is characterized by amyloid fibril deposition derived from monoclonal immunoglobulin light chains, resulting in multiorgan dysfunction. Limited data exist on the clinical features of AL amyloidosis.ObjectiveThis study aims to describe the clinical characteristics, treatments, and outcomes in Colombian patients with AL amyloidosis.MethodsA retrospective descriptive study was conducted at three high-complexity centers in Medellín, Colombia. Adults with AL amyloidosis diagnosed between 2012 and 2022 were included. Clinical, laboratory, histological, treatment, and survival data were analyzed.ResultsThe study included 63 patients. Renal involvement was most prevalent (66%), followed by cardiac involvement (61%). Multiorgan involvement occurred in 61% of patients. Amyloid deposition was most commonly detected in renal biopsy (40%). Bortezomib-based therapy was used in 68%, and 23.8% received high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDCT-ASCT). Hematological response was observed in 95% of patients with available data. Cardiac and renal organ responses were 15% and 14%, respectively. Median overall survival was 45.1 months (95% CI: 22.2-63.8). In multivariate analysis, cardiac involvement was significantly associated with inferior overall survival (HR 3.27; 95% CI: 1.23-8.73; p=0.018), HDCT-ASCT had a non-significant trend towards improved overall survival (HR 0.25; 95% CI: 0.06-1.09; p=0.065).ConclusionsIn this study of Colombian patients with AL amyloidosis, renal involvement was more frequent than cardiac involvement. Overall survival and multiorgan involvement were consistent with data from other regions of the world. Multivariate analysis identified cardiac involvement and HDCT-AHCT as possible prognostic factors.Copyright © 2023 Colombia Medica.

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