What does this research mean for the field?

Chromosome 1q gain identifies a biologically distinct, adverse-risk subtype of AL amyloidosis associated with inferior long-term survival, whereas other multiple myeloma-defined high-risk cytogenetic abnormalities lack independent prognostic relevance. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prognostic significance of multiple myeloma-defined high-risk cytogenetic abnormalities, specifically chromosome 1q gain, in AL amyloidosis.

August 27, 2026American Journal of Hematology

Chromosome 1q Gain Defines a Plasma Cell–Dominant Adverse‐Risk Subtype in AL Amyloidosis With Inferior Long‐Term Survival

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Authors

THTamer HellouMayo Clinic EGEstefania Gauto‐MariottiLoyola University Medical Center AAAhmed AlnughmushMayo Clinic

Discussion

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Implication

Retrospective study demonstrates inferior long-term survival in AL amyloidosis with chromosome 1q gain, suggesting distinct plasma cell-dominant risk biology.

Key Points

To evaluate the prognostic significance of multiple myeloma-defined high-risk cytogenetic abnormalities, specifically chromosome 1q gain, in AL amyloidosis.
Retrospectively evaluated 517 newly diagnosed AL amyloidosis patients seen at Mayo Clinic between 2012 and 2021.
Identified baseline high-risk cytogenetic abnormalities [t(4;14), t(14;16), t(14;20), del(17p), or +1q] using plasma cell fluorescence in situ hybridization (FISH).
High-risk cytogenetic abnormalities occurred in 29% of patients (151/517), with +1q comprising 81% of cases (122/151) and associating with higher clonal disease burden.
Patients with +1q had significantly shorter median overall survival compared to non-1q high-risk and standard-risk patients (57 months vs. not reached vs. 120 months, p = 0.02).
Multivariable piecewise Cox analysis demonstrated that +1q independently predicted adverse survival beyond 24 months from diagnosis (HR 2.89, 95% CI 1.64–5.09, p < 0.001), while non-1q high-risk abnormalities showed no independent prognostic relevance.

Cite This Study

Hellou et al. (2026) studied this question.

synapsesocial.com/papers/6a8fea3310c91c1e92622483 https://doi.org/10.1002/ajh.70484

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Implication

Retrospective study demonstrates inferior long-term survival in AL amyloidosis with chromosome 1q gain, suggesting distinct plasma cell-dominant risk biology.

Chromosome 1q Gain Defines a Plasma Cell–Dominant Adverse‐Risk Subtype in AL Amyloidosis With Inferior Long‐Term Survival

Discussion

Member takes

Implication

Key Points

Cite This Study

Chromosome 1q Gain Defines a Plasma Cell–Dominant Adverse‐Risk Subtype in AL Amyloidosis With Inferior Long‐Term Survival

Discussion

Member takes

Implication

Key Points

Cite This Study

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