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Blood, 15 September 2004, Vol. 104, No. 6, pp. 1881-1887. Prepublished online as a Blood First Edition Paper on March 25, 2004; DOI 10.1182/blood-2004-01-0390. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-01-0390v1 104/6/1881    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dispenzieri, A. Articles by Jaffe, A. S. Search for Related Content PubMed PubMed Citation Articles by Dispenzieri, A. Articles by Jaffe, A. S. Related Collections Hemostasis, Thrombosis, and Vascular Biology Neoplasia Transplantation Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Prognostication of survival using cardiac troponins and N-terminal pro-brain natriuretic peptide in patients with primary systemic amyloidosis undergoing peripheral blood stem cell transplantation Angela Dispenzieri, Morie A. Gertz, Robert A. Kyle, Martha Q. Lacy, Mary F. Burritt, Terry M. Therneau, Joseph P. McConnell, Mark R. Litzow, Dennis A. Gastineau, Ayalew Tefferi, David J. Inwards, Ivana N. Micallef, Stephen M. Ansell, Luis F. Porrata, Michelle A. Elliott, William J. Hogan, S. Vincent Rajkumar, Rafael Fonseca, Philip R. Greipp, Thomas E. Witzig, John A. Lust, Steven R. Zeldenrust, Denise S. Snow, Susan R. Hayman, Christopher G. A. McGregor, and Allan S. Jaffe From the Division of Hematology and Internal Medicine, the Division of Biostatistics, the Division of Cardiovascular Diseases and Internal Medicine, the Division of Laboratory Genetics, the Department of Surgery, and the Division of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, MN. Primary systemic amyloidosis (AL) is a fatal plasma cell disorder. Pilot data suggest survival is better in patients undergoing peripheral blood stem cell transplantation (PBSCT), but the selection process makes the apparent benefit suspect. We have reported that circulating cardiac biomarkers are the best predictors of survival outside of the transplantation setting. We now test whether cardiac troponins (cTnT and cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are prognostic in transplant recipients. In 98 patients with AL undergoing PBSCT, serum cardiac biomarkers were measured (cTnT, 98 patients; cTnI, 65 patients; and NT-proBNP, 63 patients). Elevated levels of cTnT, cTnI, and NT-proBNP were present in 14%, 43%, and 48% of patients, respectively. At 20 months median follow-up, median survival has not been reached for patients with values below the thresholds; in patients with values above the thresholds, median survival is 26.1 months, 66.1 months, and 66.1 months, respectively. Our previously reported risk systems incorporating these markers were also prognostic, notably the cTnT/NT-proBNP staging. Using this system, 49%, 38%, and 13% of patients were in stage I, stage II, and stage III, respectively. Determining levels of circulating biomarkers may be the most powerful tool for staging patients with AL undergoing PBSCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Sharpening therapeutic strategy in AL amyloidosis Giampaolo Merlini Blood 2004 104: 1593-1594. [Full Text] [PDF] This article has been cited by other articles: R. L. Comenzo How I treat amyloidosis Blood, October 8, 2009; 114(15): 3147 - 3157. [Abstract] [Full Text] [PDF] G. Palladini and G. Merlini Current treatment of AL amyloidosis Haematologica, August 1, 2009; 94(8): 1044 - 1048. [Full Text] [PDF] M. Emdin, S. Vittorini, C. Passino, and A. Clerico Old and new biomarkers of heart failure Eur J Heart Fail, April 1, 2009; 11(4): 331 - 335. [Abstract] [Full Text] [PDF] D Bellavia, P A Pellikka, T P Abraham, G B Al-Zahrani, A Dispenzieri, J K Oh, R E Espinosa, C G Scott, C Miyazaki, and F A Miller 'Hypersynchronisation' by tissue velocity imaging in patients with cardiac amyloidosis Heart, February 1, 2009; 95(3): 234 - 240. [Abstract] [Full Text] [PDF] A. Biolo, S. Ramamurthy, L. H. Connors, C. J. O'Hara, H. K. Meier-Ewert, P. T. Soo Hoo, D. B. Sawyer, D. S. Seldin, and F. Sam Matrix Metalloproteinases and Their Tissue Inhibitors in Cardiac Amyloidosis: Relationship to Structural, Functional Myocardial Changes and to Light Chain Amyloid Deposition Circ Heart Fail, November 1, 2008; 1(4): 249 - 257. [Abstract] [Full Text] [PDF] S. Kumar, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, N. Leung, S. R. Zeldenrust, F. K. Buadi, R. A. Kyle, S. V. Rajkumar, and M. A. Gertz Serum Uric Acid: Novel Prognostic Factor in Primary Systemic Amyloidosis Mayo Clin. Proc., March 1, 2008; 83(3): 297 - 303. [Abstract] [Full Text] [PDF] E. Kastritis, A. Anagnostopoulos, M. Roussou, S. Toumanidis, C. Pamboukas, M. Migkou, A. Tassidou, I. Xilouri, S. Delibasi, E. Psimenou, et al. Treatment of light chain (AL) amyloidosis with the combination of bortezomib and dexamethasone Haematologica, October 1, 2007; 92(10): 1351 - 1358. [Abstract] [Full Text] [PDF] B. P.C. Hazenberg, M. H. van Rijswijk, M. N. Lub-de Hooge, E. Vellenga, E. B. Haagsma, M. D. Posthumus, and P. L. Jager Diagnostic Performance and Prognostic Value of Extravascular Retention of 123I-Labeled Serum Amyloid P Component in Systemic Amyloidosis J. Nucl. Med., June 1, 2007; 48(6): 865 - 872. [Abstract] [Full Text] [PDF] N. Leung, A. Dispenzieri, M. Q. Lacy, S. K. Kumar, S. R. Hayman, F. C. Fervenza, S. S. Cha, and M. A. Gertz Severity of Baseline Proteinuria Predicts Renal Response in Immunoglobulin Light Chain-Associated Amyloidosis after Autologous Stem Cell Transplantation Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 440 - 444. [Abstract] [Full Text] [PDF] V. Sanchorawala Light-Chain (AL) Amyloidosis: Diagnosis and Treatment Clin. J. Am. Soc. Nephrol., November 1, 2006; 1(6): 1331 - 1341. [Abstract] [Full Text] [PDF] D. H. Vesole, W. S. Perez, M. Akasheh, C. Boudreau, D. E. Reece, C. N. Bredeson, and Plasma Cell Disorders Working Committee of the Cen High-Dose Therapy and Autologous Hematopoietic Stem Cell Transplantation for Patients With Primary Systemic Amyloidosis: A Center for International Blood and Marrow Transplant Research Study Mayo Clin. Proc., July 1, 2006; 81(7): 880 - 888. [Abstract] [Full Text] [PDF] A. M. S. Muller, A. Geibel, H. P. H. Neumann, A. Kuhnemund, A. Schmitt-Graff, J. Bohm, and M. Engelhardt Primary (AL) Amyloidosis in Plasma Cell Disorders Oncologist, July 1, 2006; 11(7): 824 - 830. [Abstract] [Full Text] [PDF] G. Palladini, F. Lavatelli, P. Russo, S. Perlini, V. Perfetti, T. Bosoni, L. Obici, A. R. Bradwell, G. M. D'Eril, R. Fogari, et al. Circulating amyloidogenic free light chains and serum N-terminal natriuretic peptide type B decrease simultaneously in association with improvement of survival in AL Blood, May 15, 2006; 107(10): 3854 - 3858. [Abstract] [Full Text] [PDF] S. V. Rajkumar, A. Dispenzieri, and R. A. Kyle Monoclonal Gammopathy of Undetermined Significance, Waldenstrom Macroglobulinemia, AL Amyloidosis, and Related Plasma Cell Disorders: Diagnosis and Treatment Mayo Clin. Proc., May 1, 2006; 81(5): 693 - 703. [Abstract] [Full Text] [PDF] A. Dispenzieri, M. Q. Lacy, J. A. Katzmann, S. V. Rajkumar, R. S. Abraham, S. R. Hayman, S. K. Kumar, R. Clark, R. A. Kyle, M. R. Litzow, et al. Absolute values of immunoglobulin free light chains are prognostic in patients with primary systemic amyloidosis undergoing peripheral blood stem cell transplantation Blood, April 15, 2006; 107(8): 3378 - 3383. [Abstract] [Full Text] [PDF] N. Leung, T. R. Leung, S. S. Cha, A. Dispenzieri, M. Q. Lacy, and M. A. Gertz Excessive fluid accumulation during stem cell mobilization: a novel prognostic factor of first-year survival after stem cell transplantation in AL amyloidosis patients Blood, November 15, 2005; 106(10): 3353 - 3357. [Abstract] [Full Text] [PDF] L. Babuin and A. S. Jaffe Troponin: the biomarker of choice for the detection of cardiac injury Can. Med. Assoc. J., November 8, 2005; 173(10): 1191 - 1202. [Abstract] [Full Text] [PDF] R. H. Falk Diagnosis and Management of the Cardiac Amyloidoses Circulation, September 27, 2005; 112(13): 2047 - 2060. [Full Text] [PDF] L. F. Porrata, M. A. Gertz, M. R. Litzow, M. Q. Lacy, A. Dispenzieri, D. J. Inwards, S. M. Ansell, I. N.M. Micallef, D. A. Gastineau, M. Elliott, et al. Early Lymphocyte Recovery Predicts Superior Survival after Autologous Hematopoietic Stem Cell Transplantation for Patients with Primary Systemic Amyloidosis Clin. Cancer Res., February 1, 2005; 11(3): 1210 - 1218. [Abstract] [Full Text] [PDF] H. J. B. Goodman, P. N. Hawkins, A. Dispenzieri, M. A. Gertz, R. A. Kyle, and J. Mehta The role of PBSCT in treatment of AL amyloidosis is far from settled Blood, November 1, 2004; 104(9): 2991 - 2994. [Full Text] [PDF]

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