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Abstract: PB1644

Type: Publication Only

Session title: Myeloma and other monoclonal gammopathies - Clinical

Background
AL amyloidosis is an incurable disorder. The real natural history of this condition is incompletely understood. 

Aims
In this study, we describe the natural history of the disease based on analysis of real-world longitudinal data.

Methods
All patients seen at the National amyloidosis Centre, the UK between Feb 2010 and Aug 2019 and treated with upfront Bortezomib are included in this analysis. 

Results
1276 patients received 1^st line treatment. 26% of patients had died within 12 months of 1^st line treatment. 376 (29.5%), 117 (9.2%), 32 (2.5%), 8 (0.6%) and 2 (0.2%) patients had received 2^nd, 3^rd, 4^th, 5^th and six lines of treatment, respectively. 77.2% of patients who required more than one line of treatment received the 2^nd line within the first two years of 1^st line treatment. There was no significant difference in survival from 1^st, 2^nd, 3^rd, and 4^th lines of treatment (p=.478). The OS from 1^st, 2^nd, 3^rd, and 4^th lines treatment was 56 month, 53 months, 42 months and not reached, respectively (Figure 1). There was no significant difference in TNT from 1^st, 2^nd, 3^rd, and 4^th lines of treatment (p=.901). The TNT from 1^st, 2^nd, 3^rd, and 4^th lines of treatment was 64 months, 48 months, 36 months, and 44 months, respectively (Figure 1). 

Conclusion
AL Amyloidosis is an incurable disease, and most patients require further treatment. However, even multiply relapsed AL patients have a good outcome and prolonged remission periods.  Prospective trials are needed to refine treatments in the patients with relapsed AL amyloidosis. 

Keyword(s): AL amyloidosis