Cardiac Response Dynamics in Newly Diagnosed Light-Chain Amyloidosis Patients With Early and High-Quality Hematologic Response

Figures

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  Figure 1. Flow Diagram for Landmark Analysis Cohorts A total of 201 patients were involved in the study after 105 patients were excluded because of not achieving complete response (CRH) or very good partial response (VGPRH) or dead in 3 months after treatment initiation. At every fixed time point, patients were excluded because of death or loss to follow-up. PRH = hematological partial response; Tx = treatment.

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  Figure 2. Cardiac Response Pattern (A-B) Distribution of cardiac response at each fixed time points in all patients (A) and different Mayo 2004 stages (B). (C) Distribution of cardiac response in Mayo 2004 models at 24 months. (D) Distribution of cardiac response in Mayo 2012 models at 24 months. (E) Cumulative hematological and cardiac progression rate at fixed time points. carCR = cardiac complete response; carNR = cardiac no response; carPD = cardiac progressive disease; carPR = cardiac partial response; carVGPR = cardiac very good partial response; PDH = hematological progressive disease.

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  Figure 3. The Effect of Cardiac Dynamics on OS (A) OS stratified by depth of best cardiac response at 3 months from treatment initiation. (B) Forest plots of HR for overall survival (OS) based on weather carPR or better is achieved at the fixed time point, calculated by competing risk model. The red circle represents HR and the horizontal line represents 95% CI. (C) OS stratified by time to reaching different cardiac responses. The dashed lines in the Kaplan-Meier curve plots represent the 95% CI. Abbreviations as in Figure 2.

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  Figure 4. Influencing Factors of Cardiac Response Distribution of cardiac response at 12 months in different hematological response of 3 months after treatment initiation. SRFLC = stringent response of free light chain; URFLC = unstringent response of free light chain; other abbreviations as in Figures 1 and 2.

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  Central Illustration. Cardiac Response Dynamics For newly diagnosed light-chain amyloidosis patients who achieved a high-quality hematologic response within 3 months, it is important to achieve at least cardiac partial response at 12 months for better prognosis, and NT-proBNP at 3 months could help predict the cardiac response at 12 months. At 24 months, the cardiac response reached a plateau. carCR = cardiac complete response; carNR = cardiac no response; carPR = cardiac partial response; carVGPR = cardiac very good partial response; CR = complete response; VGPR = very good partial response.