Li et al reported a staging system for systemic immunoglobulin light-chain amyloidosis with renal involvement. This can help to identify a patient who requires more aggressive management. The authors are from Southeast University and Nanjing University in China.
Patient selection: light-chain amyloidosis with renal involvement
Parameters:
(1) serum Gal-3 in ng/mL
(2) serum high-sensitivity cardiac troponin T (upper limit of normal 0.014 ng/mL)
(3) difference between the involved and uninvolved free light chain in mg/L
difference between light chains =
= (concentration of involved light chain) - (concentration of uninvolved light chain)
Parameter
Finding
Points
serum Gal-3
< 20.24 ng/mL
0
>= 20.24 ng/mL
1
serum hs troponin T
< 0.026 ng/mL
0
>= 0.026 ng/mL
1
light chain difference
< 75.89 mg/L
0
>= 75.89 mg/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
Total Score
Stage
5-Year Survival Rate
0
1
77.7%
1
2
49.4%
2
3
24.4%
3
4
4.7%
Performance:
• The area under the ROC curve is 0.71.
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