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Prognostic value of NT-ProBNP and troponin T in patients with light chain amyloidosis and kidney dysfunction undergoing autologous stem cell transplantation

Bone Marrow Transplantation volume 56, pages 274–277 (2021)Cite this article

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The interpretation of N-terminal-pro hormone brain natriuretic peptide (NT-ProBNP) and Troponin T levels can be difficult in the presence of kidney dysfunction, as they are renally excreted [1, 2]. We evaluated the prognostic value of these biomarkers in patients with light chain (AL) amyloidosis and kidney dysfunction.

We identified patients with a diagnosis of AL amyloidosis according the consensus criteria [3] who were transplanted between March 1996 and August 2017 and who had a Cr > 1 mg/dl and a glomerular filtration rate (GFR) ≤ 90. Cardiac biomarkers and Mayo 2012 stage [4] were recorded before autologous stem cell transplantation (ASCT). Response was evaluated at day 100 post ASCT [5]. The study was approved by the Mayo Clinic Institutional Review Board.

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Fig. 1: PFS and OS for the different GFR groups according to the NT-ProBNP levels (a–f) and according to Troponin T levels (g–l).

References

  1. Dittrich T, Benner A, Kimmich C, Siepen FAD, Veelken K, Kristen AV, et al. Performance analysis of AL amyloidosis cardiac biomarker staging systems with special focus on renal failure and atrial arrhythmia. Haematologica. 2019;104:1451–9.

    Article  Google Scholar 

  2. Manzano-Fernandez S, Januzzi JL, Boronat-Garcia M, Pastor P, Albaladejo-Oton MD, Garrido IP, et al. Impact of kidney dysfunction on plasma and urinary N-terminal pro-B-type natriuretic peptide in patients with acute heart failure. Congest Heart Fail. 2010;16:214–20.

    Article  CAS  Google Scholar 

  3. Gertz MA, Comenzo R, Falk RH, Fermand JP, Hazenberg BP, Hawkins PN, et al. Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, 18-22 April 2004. Am J Hematol. 2005;79:319–28.

    Article  Google Scholar 

  4. Kumar S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Colby C, et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. J Clin Oncol. 2012;30:989–95.

    Article  CAS  Google Scholar 

  5. Palladini G, Dispenzieri A, Gertz MA, Kumar S, Wechalekar A, Hawkins PN, et al. New criteria for response to treatment in immunoglobulin light chain amyloidosis based on free light chain measurement and cardiac biomarkers: impact on survival outcomes. J Clin Oncol. 2012;30:4541–9.

    Article  CAS  Google Scholar 

  6. Vickery S, Price CP, John RI, Abbas NA, Webb MC, Kempson ME, et al. B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy. Am J Kidney Dis. 2005;46:610–20.

    Article  CAS  Google Scholar 

  7. Palladini G, Foli A, Milani P, Russo P, Albertini R, Lavatelli F, et al. Best use of cardiac biomarkers in patients with AL amyloidosis and renal failure. Am J Hematol. 2012;87:465–71.

    Article  CAS  Google Scholar 

  8. Gertz MA, Lacy MQ, Dispenzieri A, Kumar SK, Dingli D, Leung N, et al. Refinement in patient selection to reduce treatment-related mortality from autologous stem cell transplantation in amyloidosis. Bone Marrow Transpl. 2013;48:557–61.

    Article  CAS  Google Scholar 

  9. Sidiqi MH, Aljama MA, Buadi FK, Warsame RM, Lacy MQ, Dispenzieri A, et al. Stem cell transplantation for light chain amyloidosis: decreased early mortality over time. J Clin Oncol. 2018;36:1323–9.

    Article  Google Scholar 

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Author notes

  1. These authors contributed equally: Abdullah S. Al Saleh, Harsh Parmar

Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Abdullah S. Al Saleh, Harsh V. Parmar, Iuliana Vaxman, Alissa Visram, M. Hasib Sidiqi, Eli Muchtar, Francis K. Buadi, Angela Dispenzieri, Rahma Warsame, Martha Q. Lacy, David Dingli, Wilson I. Gonsalves, Taxiarchis V. Kourelis, William J. Hogan, Suzanne R. Hayman, Prashant Kapoor, Shaji K. Kumar & Morie A. Gertz

  2. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Abdullah S. Al Saleh

  3. Institute of Hematology, Davidoff cancer center, Rabin medical center, Petah Tikva, Israel

    Iuliana Vaxman

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Iuliana Vaxman

  5. Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia

    M. Hasib Sidiqi

  6. Department of Pharmacy, Mayo Clinic, Rochester, MN, USA

    Robert C. Wolf

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  1. Abdullah S. Al Saleh
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Contributions

ASA and HP designed the study, analyzed the data, wrote the first draft, and approved the final version of the manuscript. JV, AV, and MHS collected the data, revised the manuscript and approved the final version of the manuscript. EM, FKB, AD, RW, MQL, DD, WIG, RCW, TVK, WJH, SRH, PK, and SKK performed patient management, revised the manuscript critically, and approved the final version of the manuscript; and MAG designed the study, analyzed the data, wrote the first draft, approved the final version of the manuscript, and performed patient management.

Corresponding author

Correspondence to Morie A. Gertz.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Mayo Clinic institutional review board.

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Al Saleh, A.S., Parmar, H.V., Vaxman, I. et al. Prognostic value of NT-ProBNP and troponin T in patients with light chain amyloidosis and kidney dysfunction undergoing autologous stem cell transplantation. Bone Marrow Transplant 56, 274–277 (2021). https://doi.org/10.1038/s41409-020-0990-6

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  • DOI: https://doi.org/10.1038/s41409-020-0990-6

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