{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:57:32Z","timestamp":1785585452183,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This national, multicenter, retrospective study analyzed 1070 patients with newly diagnosed systemic light\u2010chain (AL) amyloidosis in China (2008\u20132025). Findings reveal increasing annual diagnoses and a marked shift in first\u2010line therapy from proteasome inhibitor (PI)\u2010based regimens to predominantly daratumumab\u2010based regimens since 2024. Monthly kinetic assessments demonstrated that daratumumab\u2010based induction produced deeper and faster hematologic responses than PI\u2010based therapy [\u2265\u2009very good hematologic partial response (HemVGPR): 80.3% vs. 70.8%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.012; median time to \u2265\u2009HemVGPR: 1.2 vs. 1.8\u2009months,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001], with significantly superior cardiac overall response (63.1% vs. 53.3%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.030). Early mortality rates at 1, 3, and 6\u2009months were 5.5%, 13.2%, and 16.2%, respectively, with daratumumab\u2010based therapy identified as an independent protective factor for 6\u2010month mortality. Median event\u2010free survival (EFS) was 44.4\u2009months, while median overall survival (OS) was not reached. Achievement of hematologic complete response (HemCR) conferred superior EFS and OS over HemVGPR (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), with minimal residual disease negativity further improving EFS in HemCR patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.043). Concurrent hepatic and cardiac involvement defined a high\u2010risk subgroup with poor outcomes (median EFS 12.8\u2009months, OS 51.0\u2009months). Multivariable analysis confirmed Eastern Cooperative Oncology Group (ECOG) performance status (PS) &gt;\u20092, liver involvement, and gain1q as adverse prognostic factors for EFS, whereas \u2265\u2009HemVGPR was protective. For OS, liver involvement, concomitant multiple myeloma, and ECOG PS &gt;\u20092 were independent risk factors, while \u2265\u2009HemVGPR and cardiac response predicted improved survival. This study establishes a contemporary benchmark for AL amyloidosis management in China, confirming the superior real\u2010world efficacy of daratumumab\u2010based frontline therapy.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70418","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T09:48:14Z","timestamp":1782208094000},"page":"2230-2245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multicenter National Study of\n                    <scp>AL<\/scp>\n                    Amyloidosis in China: Insights Into Real\u2010World Diagnosis, Treatment, and Prognosis"],"prefix":"10.1002","volume":"101","author":[{"given":"Jing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Hematology, Zhongshan Hospital Fudan University  Shanghai 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