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Impact of involved free light chain (FLC) levels in patients achieving normal FLC ratio after initial therapy in light chain amyloidosis (AL)

Overview of attention for article published in American Journal of Hematology, October 2017
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Title
Impact of involved free light chain (FLC) levels in patients achieving normal FLC ratio after initial therapy in light chain amyloidosis (AL)
Published in
American Journal of Hematology, October 2017
DOI 10.1002/ajh.24919
Pubmed ID
Authors

Nidhi Tandon, Surbhi Sidana, Angela Dispenzieri, Morie A. Gertz, Martha Q. Lacy, David Dingli, Francis K. Buadi, Amie L. Fonder, Suzanne R. Hayman, Yi Lisa Hwa, Miriam A. Hobbs, Prashant Kapoor, Wilson I. Gonsalves, Nelson Leung, Ronald S. Go, John A. Lust, Stephen J. Russell, Robert A. Kyle, S. Vincent Rajkumar, Shaji K. Kumar

Abstract

Achievement of a normal FLC ratio (FLCr) following treatment indicates hematologic response and suggests better outcomes in light chain amyloidosis (AL). We examined if elevated involved free light chain (hiFLC) impacts outcomes in patients achieving normal FLCr. We retrospectively analyzed 345 AL patients who were diagnosed within a 10-year period (2006-2015) and had 2 consecutive normal FLCr values after 1st line treatment. Among these, patients with hiFLC at 1(st) reading of normal FLCr (hiFLC1; n=166; 48.1%) were compared to those who did not (n=179; 51.9%). Patients with AL who have hiFLC1 after initial therapy had higher rates of multi-organ involvement (63.3 vs 46.4%; p=0.002) and patients in advanced Mayo stage (42.9 vs 32.2%; p=0.04) at diagnosis. The median progression free survival [PFS; 38.2 (95%CI; 26.4, 55.4) vs 67.1 (95%CI; 55.8, 88) months; p=0.0002] and overall survival [OS; 94.4 (95%CI; 78, 107.1) vs not reached (NR, 95%CI; 116.1, NR) months; p<0.0001] were lower in those who had hiFLC1. A more stringent comparison for patients with 2 consecutive hiFLC (hIFLC2; n=111; 32.2%) versus not (n=2234; 67.8%) showed consistent results [PFS; 27.1 (95%CI; 23, 53.8) vs 63.3 (95%CI; 55.4, 77) months; p<0.0001 and OS; 78 (95% CI; 54.6, 98.8) vs NR (95%CI; NR, NR); p<0.0001]. This poor prognostic impact of hiFLC on survival was independent of serum creatinine, Mayo stage, negative immunofixation status and inclusion of transplant in initial therapy on multivariate analysis. Hence, persistent elevation of iFLC predicts poor prognosis even among patients achieving normal ratio after initial therapy in AL. This article is protected by copyright. All rights reserved.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Professor 2 10%
Researcher 2 10%
Student > Postgraduate 2 10%
Student > Ph. D. Student 2 10%
Student > Doctoral Student 1 5%
Other 4 19%
Unknown 8 38%
Readers by discipline Count As %
Medicine and Dentistry 7 33%
Biochemistry, Genetics and Molecular Biology 2 10%
Agricultural and Biological Sciences 1 5%
Social Sciences 1 5%
Psychology 1 5%
Other 0 0%
Unknown 9 43%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 October 2017.
All research outputs
#13,830,150
of 24,477,448 outputs
Outputs from American Journal of Hematology
#2,110
of 3,570 outputs
Outputs of similar age
#156,805
of 333,509 outputs
Outputs of similar age from American Journal of Hematology
#34
of 72 outputs
Altmetric has tracked 24,477,448 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,570 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.8. This one is in the 40th percentile – i.e., 40% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 333,509 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 52% of its contemporaries.
We're also able to compare this research output to 72 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.