Patients’ characteristics
| Variable . | Pavia cohort (n = 461) . | Heidelberg cohort (n = 271) . | P . |
|---|---|---|---|
| n (%) or median (IQR) . | n (%) or median (IQR) . | ||
| Age, y | 64 (56-61) | 61 (54-68) | <.001 |
| Gender, male | 264 (57) | 159 (59) | .710 |
| Organ involvement | |||
| Heart | 322 (70) | 190 (70) | .940 |
| Liver | 75 (16) | 72 (27) | .001 |
| Peripheral nervous system | 55 (12) | 39 (14) | .337 |
| Soft tissues | 49 (11) | 91 (33) | <.001 |
| Cardiac stage I/II/III | 105 (23)/196 (42)/160 (35) | 59 (27)/89 (41)/70 (32)* | .504 |
| NT-proBNP > 8500 ng/L† | 85 (18) | 43 (16) | .377 |
| Proteinuria, g/24 h | 5.1 (2.3-9.4) | 6.0 (3.3-9.0) | .046 |
| Serum creatinine, mg/dL | 1.11 (0.87-1.70) | 1.1 (0.83-1.63) | .184 |
| eGFR, mL/min per 1.73 m2 | 62 (38-84) | 64 (42-88) | .204 |
| CKD stage 1/2/3/4/5 | 94 (21)/148 (32)/139 (30)/53 (11)/27 (6) | 65 (24)/92 (34)/73 (27)/34 (12)/7 (3) | .154 |
| dFLC, mg/L | 160 (62-402) | 126 (54-306) | .219 |
| Type of first-line treatment | |||
| Melphalan + dexamethasone | 214 (46.4) | 87 (32.1) | <.001 |
| Bortezomib based | 128 (27.8) | 55 (20.3) | .024 |
| Thalidomide based | 57 (12.4) | 1 (0.4) | <.001 |
| Dexamethasone alone | 34 (7.4) | 8 (2.9) | <.001 |
| Autologous stem cell transplant | 19 (4.1) | 80 (29.5) | <.001 |
| Treatment of IgM clones | 9 (1.9) | 1 (0.4) | — |
| Melphalan + prednisone | 0 (0.0) | 16 (5.9) | — |
| Anthracycline based | 0 (0.0) | 9 (3.3) | — |
| Bendamustine | 0 (0.0) | 1 (0.4) | — |
| Untreated | 0 (0.0) | 13 (4.8) | — |
| Type of second-line treatment | |||
| Bortezomib based | 79 (42.5) | 62 (60.2) | .004 |
| Thalidomide based | 39 (21.0) | 6 (5.8) | <.001 |
| Lenalidomide based | 19 (10.2) | 13 (12.6) | .532 |
| Melphalan + dexamethasone | 19 (10.2) | 14 (13.6) | .387 |
| Autologous stem cell transplant | 18 (9.7) | 0 (0.0) | .001 |
| Pomalidomide-dexamethasone | 5 (2.7) | 0 (0.0) | — |
| Treatment of IgM clones | 4 (2.1) | 2 (1.9) | — |
| Dexamethasone alone | 3 (1.6) | 0 (0.0) | — |
| Bendamustine | 0 (0.0) | 3 (2.9) | — |
| Ixazomib | 0 (0.0) | 2 (1.9) | — |
| Melphalan + prednisone | 0 (0.0) | 1 (1.0) | — |
| Variable . | Pavia cohort (n = 461) . | Heidelberg cohort (n = 271) . | P . |
|---|---|---|---|
| n (%) or median (IQR) . | n (%) or median (IQR) . | ||
| Age, y | 64 (56-61) | 61 (54-68) | <.001 |
| Gender, male | 264 (57) | 159 (59) | .710 |
| Organ involvement | |||
| Heart | 322 (70) | 190 (70) | .940 |
| Liver | 75 (16) | 72 (27) | .001 |
| Peripheral nervous system | 55 (12) | 39 (14) | .337 |
| Soft tissues | 49 (11) | 91 (33) | <.001 |
| Cardiac stage I/II/III | 105 (23)/196 (42)/160 (35) | 59 (27)/89 (41)/70 (32)* | .504 |
| NT-proBNP > 8500 ng/L† | 85 (18) | 43 (16) | .377 |
| Proteinuria, g/24 h | 5.1 (2.3-9.4) | 6.0 (3.3-9.0) | .046 |
| Serum creatinine, mg/dL | 1.11 (0.87-1.70) | 1.1 (0.83-1.63) | .184 |
| eGFR, mL/min per 1.73 m2 | 62 (38-84) | 64 (42-88) | .204 |
| CKD stage 1/2/3/4/5 | 94 (21)/148 (32)/139 (30)/53 (11)/27 (6) | 65 (24)/92 (34)/73 (27)/34 (12)/7 (3) | .154 |
| dFLC, mg/L | 160 (62-402) | 126 (54-306) | .219 |
| Type of first-line treatment | |||
| Melphalan + dexamethasone | 214 (46.4) | 87 (32.1) | <.001 |
| Bortezomib based | 128 (27.8) | 55 (20.3) | .024 |
| Thalidomide based | 57 (12.4) | 1 (0.4) | <.001 |
| Dexamethasone alone | 34 (7.4) | 8 (2.9) | <.001 |
| Autologous stem cell transplant | 19 (4.1) | 80 (29.5) | <.001 |
| Treatment of IgM clones | 9 (1.9) | 1 (0.4) | — |
| Melphalan + prednisone | 0 (0.0) | 16 (5.9) | — |
| Anthracycline based | 0 (0.0) | 9 (3.3) | — |
| Bendamustine | 0 (0.0) | 1 (0.4) | — |
| Untreated | 0 (0.0) | 13 (4.8) | — |
| Type of second-line treatment | |||
| Bortezomib based | 79 (42.5) | 62 (60.2) | .004 |
| Thalidomide based | 39 (21.0) | 6 (5.8) | <.001 |
| Lenalidomide based | 19 (10.2) | 13 (12.6) | .532 |
| Melphalan + dexamethasone | 19 (10.2) | 14 (13.6) | .387 |
| Autologous stem cell transplant | 18 (9.7) | 0 (0.0) | .001 |
| Pomalidomide-dexamethasone | 5 (2.7) | 0 (0.0) | — |
| Treatment of IgM clones | 4 (2.1) | 2 (1.9) | — |
| Dexamethasone alone | 3 (1.6) | 0 (0.0) | — |
| Bendamustine | 0 (0.0) | 3 (2.9) | — |
| Ixazomib | 0 (0.0) | 2 (1.9) | — |
| Melphalan + prednisone | 0 (0.0) | 1 (1.0) | — |
The differences in treatment reflected different strategies over time. Chronic kidney disease stages are defined according to eGFR as follows: stage I, ≥90 mL/min per 1.73 m2; stage II, 60 to 89 mL/min per 1.73 m2; stage III, 30 to 59 mL/min per 1.73 m2; stage IV, 15-29 mL/min per 1.73 m2; and stage V, <15 mL/min per 1.73 m2.
CKD, chronic kidney disease; dFLC, difference between involved (amyloidogenic) and uninvolved free light chain; IgM, immunoglobulin M; IQR, interquartile range; NT-proBNP, N-terminal pro–natriuretic peptide type B.
Available in 218 patients.
The 8500 ng/L NT-proBNP cutoff identifies patients with advanced cardiac involvement.8