Impact of time to diagnosis on Mayo stages, treatment outcome, and survival in patients with AL amyloidosis and cardiac involvement

Abstract

Objective: To study the impact of time to diagnosis on cardiac Mayo stages, treatment outcome, and overall survival. Methods: We retrospectively analyzed 77 consecutive patients diagnosed between 2015 and 2020 with AL amyloidosis and cardiac involvement. Medical history was recorded in standardized form with the help of a questionnaire. Results: Time from onset of symptoms of cardiac failure to diagnosis was correlated with the severity of cardiac involvement in modified Mayo 2004 and revised Mayo 2012 staging systems (rs = 0.30, 95% CI: 0.07-0.50, P =.007 and rs = 0.25, 95% CI: 0.01-0.45, P =.03). Patients with advanced Mayo 2004 stages received reduced-intensity regimens and had a lower probability to achieve adequate hematologic- and cardiac response after first-line treatment than patients with early stages (rs = 0.28, 95% CI: 0.04-0.48, P =.01 and rs = 0.72, 95% CI: 0.55-0.82, P