Citations 1
Predictors of renal response in AL amyloidosis following anti‐plasma cell therapy: The impact of baseline serum free light chain levels and light chain isotype
Rees, Matthew J., Yohannan, Binoy, Geyer, Susan M. , Atallah‐Yunes, Suheil Albert , Toumeh, Nadia , Gertz, MA, Dispenzieri, Angela, Leung, Nelson , Hayman, Suzanne, Buadi, Francis, Dingli, David, Warsame, Rahma, Kapoor, Prashant , Kourelis, Taxiarchis, Gonsalves, Wilson, Kumar, Shaji, Gertz, Morie A. , Geyer, Susan , Gertz, Morie A , Cook, Joselle M , Rajkumar, S Vincent , Muchtar, E , Leung, Nelson , Atallah-Yunes, Albert , Rees, Matthew J. , Yohannan, Binoy, Dispenzieri, Angela , Hayman, S., Buadi, Francis K. , Cook, Joselle , Dingli, David , Warsame, Rahma , Binder, Moritz , Kourelis, Taxiarchis , Gonsalves, Wilson I. , Rajkumar, S. Vincent , Kumar, Shaji , Muchtar, Eli
British Journal of Haematology | May 11, 2026 | Volume: 209 | Issue: 1 | Pages: 149-159
Summary Renal response (RenR) in light‐chain (AL) amyloidosis is associated with a lower risk of end‐stage kidney disease and improved survival. However, substantial variation exists in the time to and depth of RenR. We investigated variables associated with RenR in a retrospective study of newly diagnosed AL amyloidosis patients ( n = 350) assessable for RenR between 2010 and 2022. RenRs were recorded at 6, 12 and 24 months and best response. Deep RenR was defined as a ≥renal very good partial response (RenVGPR, >60% reduction in 24‐h proteinuria or ≤200 mg). Logistic regression and competing risk methods were used to examine variables associated with RenR. The median age was 64 years, and median follow‐up was 5.5 years. On multivariable logistic regression, obtaining ≥HemVGPR within 6 months, kappa isotype, high baseline difference between involved and uninvolved free light chains (dFLC ≥40 mg/dL), renal stage and autologous haematopoietic stem cell transplant (AHSCT) were significantly associated with deep RenR. Cumulative incidence rates for deep RenR, treating death or renal progression as a competing event, demonstrated that early HemR, first‐line AHSCT, lower renal stage and dFLC ≥40 mg/dL significantly increased the likelihood of deep RenR. Specific clonal plasma cell features, namely light‐chain isotype and baseline dFLC levels, independently influence the timing and depth of RenRs in AL amyloidosis following treatment, in addition to renal stage and HemR.