Renal response to treatment in patients with Immunoglobulin Light Chain Amyloidosis

DELFINA CIRELLI; CARRETERO, MARCELINA; ADELA AGUIRRE; MARIA LOURDES POSADAS MARTINEZ

Simposio; International Symposium on Amyloidosis 2024; 2024

ID 107 Delfina Cirelli; Carolina Elena Wang; Carlos Federico Varela; María Adela Aguirre; Elsa Mercedes Nucifora; Erika Barbara Brulc; Patricia Beatriz Sorroche; María Soledad Saez; Marcelina Carretero; María Lourdes Posadas Martínez.Submitting Author: Delfina Cirelli. Hospital Italiano de Buenos Aires. Ciudad Autónoma de Buenos Aires. Argentina.Main Body of the AbstractBackground: Two-thirds of patients with AL amyloidosis had renal involvement. First-line treatment consists of chemotherapy or chemotherapy followed by autologous stem cell transplantation (ASCT) to reduce light chain production. Renal response can be observed as early as 3 months after initiation of treatment.Objective: Estimate the percentage of patients with AL amyloidosis and renal involvement who achieved renal response following first-line treatment.Materials & methods: Closed retrospective cohort study. All consecutive patients belonging to an institutional registry and diagnosed with AL amyloidosis and renal involvement from February 1, 2003, until April 30, 2022, were included and followed for 12 months. The renal response rate was estimated as a percentage with a 95% confidence interval.Results: Forty-three patients were included. Regarding first-line treatment, 70% (n=30) of patients received chemotherapy exclusively and 30% (n=13) received chemotherapy followed by ASCT. Complete renal response rates were 46% (29-63 95%CI) at 6-month and 43% (26-63 CI95%) at one-year follow-up. In contrast, 26% (13-43 CI95%) and 43% (26-63 CI95%) of patients encountered renal progression at 6-month and on-year follow-up, respectively.When differentiating groups based on the received first-line treatment regimen, those who received chemotherapy followed by ASCT showed higher complete renal response at both 6 and 12 months, with lower renal progression at 12 months (Table 1).Summary & conclusion: The first-line treatment improved renal function and reduced proteinuria in a significant percentage of patients. This was observed primarily in those who received chemotherapy followed by ASCT as initial treatment.