{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:46:44Z","timestamp":1779889604471,"version":"3.53.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Renal AL amyloidosis can be complicated by end\u2010stage renal disease (ESRD) requiring renal replacement therapy (RRT). In this study, we describe the long\u2010term outcomes of renal AL amyloidosis patients undergoing autologous stem cell transplantation (ASCT) and assess the utility of the renal staging system. Retrospective study of renal AL patients (<jats:italic>n<\/jats:italic>\u2009=\u2009697; Mayo Clinic, Boston University) who underwent ASCT between 2003 and 2020. Renal stage was assigned based on 24\u2010h proteinuria and estimated glomerular filtration rate measurements. Renal survival was defined as the time from ASCT until initiation of RRT, while patients who were not placed on RRT were censored at their last follow\u2010up. With a median follow\u2010up of 10.4\u2009years, RRT was required in 149 patients (21%). The median time from ASCT to ESRD was 3.4\u2009years, with late events of progression to ESRD seen &gt;10\u2009years from ASCT. Pre\u2010ASCT renal stage was significantly associated with the cumulative incidence of RRT: 3\u2010year RRT rate was 3%, 10%, and 37% for renal stages I, II, and III, respectively. However, in the 2012\u20132020 period subset, a significant decrease in ESRD risk was noted across all renal stages (3\u2010year RRT 0%, 5%, and 24%, respectively). In multivariate analysis, renal survival was independently associated with the pre\u2010ASCT renal stage, lambda isotype, bone marrow plasmacytosis \u226520%, post\u2010ASCT hematologic response, and year of ASCT. Long\u2010term outcomes of renal AL amyloidosis treated with ASCT are presented. Renal stage reliably predicts renal outcomes in patients with AL undergoing ASCT, despite a reduction in the proportion of patients progressing to RRT in recent years.<\/jats:p>","DOI":"10.1002\/ajh.27460","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T13:29:07Z","timestamp":1724938147000},"page":"2118-2126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long\u2010term outcomes of renal <scp>AL<\/scp> amyloidosis patients undergoing autologous stem cell transplantation: Validating the performance of the renal staging system"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-2174","authenticated-orcid":false,"given":"Eli","family":"Muchtar","sequence":"first","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3853-5196","authenticated-orcid":false,"given":"Morie A.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-2703","authenticated-orcid":false,"given":"Hamza","family":"Hassan","sequence":"additional","affiliation":[{"name":"Amyloidosis Center Boston University Chobanian &amp; Avedisian School of Medicine and Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-9512","authenticated-orcid":false,"given":"Angela","family":"Dispenzieri","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-1411","authenticated-orcid":false,"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"},{"name":"Division of Nephrology and Hypertension Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis K","family":"Buadi","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dingli","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Staron","sequence":"additional","affiliation":[{"name":"Amyloidosis Center Boston University Chobanian &amp; 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