{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:46:23Z","timestamp":1793324783216,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Systemic AL amyloidosis is a clonal plasma cell dyscrasia, where toxic free light chains (FLCs) lead to vital organ damage, with risk of early mortality despite effective therapies. Notably, there is a paucity of data on the incidence and predictors of early mortality in the daratumumab (Dara) era. We conducted a multi\u2010center retrospective cohort study to develop and validate a risk\u2010prediction model for early mortality (all\u2010cause death within 6\u2009months) in patients treated with Dara\u2010based frontline regimens. We used univariate analysis to identify covariates for a logistic regression model predictive of 6\u2010month mortality and generated a clinical risk score. Among 339 patients across eight centers, 36 (10.6%) experienced early mortality. Multivariate analysis identified four independent predictors: NT\u2010proBN\n                    <jats:styled-content>P<\/jats:styled-content>\n                    &gt;\u20095300\u2009pg\/mL (odds ratio [OR] 3.83,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006),\n                    <jats:styled-content>A<\/jats:styled-content>\n                    ge\u2009&gt;\u200975\u2009years (OR 2.96,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.073), absence of t(11;14) on\n                    <jats:styled-content>C<\/jats:styled-content>\n                    ytogenetics (OR 3.0,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.022), and\n                    <jats:styled-content>E<\/jats:styled-content>\n                    COG performance status (OR 1.72 per unit increase,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.044). The resulting PACE score stratified patients into three risk groups with a 6\u2010month mortality of 1.2% (low\u2010risk), 11.7% (intermediate\u2010risk), and 50.0% (high\u2010risk). The PACE score demonstrated superior discrimination (C\u2010index 0.78) for early mortality compared to Mayo 2004 (0.69) and Mayo 2012 (0.55) staging systems. External validation confirmed robust discrimination (C\u2010index 0.73) with corresponding 6\u2010month mortality rates of 4.2%, 15.25%, and 37.04% across respective risk groups. The PACE score provides a clinically applicable tool for early mortality risk stratification in AL amyloidosis patients receiving Dara\u2010based therapy, and will enable improved patient counseling, clinical trial design, and identification of ultra\u2010high\u2010risk patients requiring intensive monitoring and novel therapies.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70257","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:36:29Z","timestamp":1772973389000},"page":"768-783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predicting Early Mortality in Newly Diagnosed\n                    <scp>AL<\/scp>\n                    Amyloidosis: Development and Validation of the\n                    <scp>PACE<\/scp>\n                    Score for Daratumumab\u2010Treated Patients"],"prefix":"10.1002","volume":"101","author":[{"given":"George S.","family":"Mellgard","sequence":"first","affiliation":[{"name":"Department of Medicine Columbia University Irving Medical Center  New York New York USA"},{"name":"Department of Hematology\/Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul\u2010Hamid","family":"Bazarbachi","sequence":"additional","affiliation":[{"name":"Columbia University Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"Sorbonne University, Service d\u2019Hematologie Clinique et Th\u00e9rapie Cellulaire, H\u00f4pital Saint Antoine, and INSERM UMR 938  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Zanwar","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6746","authenticated-orcid":false,"given":"Ute","family":"Hegenbart","sequence":"additional","affiliation":[{"name":"Medical Department V, Amyloidosis Center University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geethika","family":"Bodanapu","sequence":"additional","affiliation":[{"name":"Boston Medical Center and Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5482-7543","authenticated-orcid":false,"given":"Divaya","family":"Bhutani","sequence":"additional","affiliation":[{"name":"Columbia University Herbert Irving Comprehensive Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GuiZhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-5643","authenticated-orcid":false,"given":"Anita","family":"D\u2019Souza","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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\/0000-0002-3853-5196","authenticated-orcid":false,"given":"Morie","family":"Gertz","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaji","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Lentzsch","sequence":"additional","affiliation":[{"name":"Columbia University Herbert Irving Comprehensive Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine University of Pavia  Pavia Italy"},{"name":"Amyloidosis Research and Treatment Center Foundation \u201cIstituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo\u201d  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Muchtar","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5994-5138","authenticated-orcid":false,"given":"Giovanni","family":"Palladini","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine University of Pavia  Pavia Italy"},{"name":"Amyloidosis Research and Treatment Center Foundation \u201cIstituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo\u201d  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despina","family":"Trajanova","sequence":"additional","affiliation":[{"name":"Medical Department V, Amyloidosis Center University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anannya","family":"Patwari","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6307-2445","authenticated-orcid":false,"given":"Vaishali","family":"Sanchorawala","sequence":"additional","affiliation":[{"name":"Boston Medical Center and Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Mohty","sequence":"additional","affiliation":[{"name":"Sorbonne University, Service d\u2019Hematologie Clinique et Th\u00e9rapie Cellulaire, H\u00f4pital Saint Antoine, and INSERM UMR 938  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikun","family":"Wang","sequence":"additional","affiliation":[{"name":"Columbia University Herbert Irving Comprehensive Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-5832","authenticated-orcid":false,"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens School of Medicine  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-0351","authenticated-orcid":false,"given":"Foteini","family":"Theodorakakou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens School of Medicine  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sch\u00f6nland","sequence":"additional","affiliation":[{"name":"Medical Department V, Amyloidosis Center University of Heidelberg  Heidelberg 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