Experience in the diagnosis and treatment of AL amyloidosis in a high-complexity center in Medellín, Colombia

1 In patients with multiple myeloma, it is necessary to have high clinical suspicion to rule out the presence of AL amyloidosis. 2 Early recognition of AL amyloidosis will improve the prognosis of these patients. Ou r is to describe the demographic, clinical, paraclinical, imaging, therapeutic and prognostic characteristics in patients with immunoglobulin light chain (AL) amyloidosis in a high complexity institution. A retrospective cohort of patients with a diagnosis of AL amyloidosis was assessed at the Pablo Tobón Uribe Hospital in the city of Medellín, Colombia, during the period from January 2010 to May 2023. A total of 33 patients were included. Of whom 20 (60.6%) were women, the median age was 62 years (Range 48 to 77). The median time between diagnosis and start of treatment was 11 days. The median follow-up of the cohort was 21 months. According to the revised Mayo Clinic staging system , disease stratification was 29.6%, 44.4%, 11.1% and 7% for stages I, II, III and IV respectively. Multiple myeloma and Waldenstrom's macroglobulinemia was reported to coexist in 22 (66%) and one patient (3%), respectively . The median overall survival was 70.9 months (95% CI, 43.7-98.1), with a reduction in survival to 56 months (95% CI, 27-85) in patients with cardiac involvement and 54.9 months (95% CI, 28.2-81.7) in those with concurrent multiple myeloma. In contrast, patients who underwent hematopoietic transplantation had a longer survival of 115.4 months (95% CI, 79.2-151.5). Our findings largely corroborate the data reported in literature, differing in certain characteristics, such as the predominance in women and the high concomitance with multiple myeloma. The factors associated with the worst prognosis were cardiac involvement and its association with multiple myeloma.