{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T08:39:54Z","timestamp":1789634394648,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the impact of time to diagnosis on cardiac Mayo stages, treatment outcome, and overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 77 consecutive patients diagnosed between 2015 and 2020 with AL amyloidosis and cardiac involvement. Medical history was recorded in standardized form with the help of a questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Time from onset of symptoms of cardiac failure to diagnosis was correlated with the severity of cardiac involvement in modified Mayo 2004 and revised Mayo 2012 staging systems (<jats:italic>r<jats:sub>s<\/jats:sub>\u00a0<\/jats:italic>=\u00a00.30, 95% CI: 0.07\u20100.50, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.007 and <jats:italic>r<jats:sub>s<\/jats:sub>\u00a0<\/jats:italic>=\u00a00.25, 95% CI: 0.01\u20100.45, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03). Patients with advanced Mayo 2004 stages received reduced\u2010intensity regimens and had a lower probability to achieve adequate hematologic\u2010 and cardiac response after first\u2010line treatment than patients with early stages (<jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>\u00a0=\u00a00.28, 95% CI: 0.04\u20100.48, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01 and <jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic>\u00a0=\u00a00.72, 95% CI: 0.55\u20100.82, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001) and poorer overall survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0004). Compared with patients diagnosed within the first year, patients diagnosed after 13\u201018 or \u226519\u00a0months from first symptoms had a 3\u2010 to 5 times higher risk of dying. Our data indicate that there is a 12\u2010month window within which the diagnosis of AL amyloidosis needs to be established to avoid early deterioration and death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sensitizing physicians and raising awareness for the disease are crucial for timely diagnosis and may improve the outcome of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13681","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T14:56:49Z","timestamp":1624978609000},"page":"449-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Impact of time to diagnosis on Mayo stages, treatment outcome, and survival in patients with AL amyloidosis and cardiac involvement"],"prefix":"10.1111","volume":"107","author":[{"given":"Sara","family":"Oubari","sequence":"first","affiliation":[{"name":"Department of Hematology and Stem Cell Transplantation West German Cancer Center University Hospital Essen Essen Germany"},{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyad","family":"Naser","sequence":"additional","affiliation":[{"name":"Institute of Molecular Biology University of Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Papathanasiou","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"},{"name":"Department of Cardiology and Vascular Medicine West German Heart and Vascular Center University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Luedike","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"},{"name":"Department of Cardiology and Vascular Medicine West German Heart and Vascular Center University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Hagenacker","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"},{"name":"Department of Neurology University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Thimm","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"},{"name":"Department of Neurology University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Rischpler","sequence":"additional","affiliation":[{"name":"Interdisciplinary Amyloidosis Network University Hospital Essen Essen Germany"},{"name":"Department of Nuclear Medicine University Hospital Essen Essen 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Center Heidelberg University Hospital Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine West German Heart and Vascular Center University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Christian","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Department of Hematology and Stem Cell Transplantation West German Cancer Center University Hospital Essen Essen Germany"},{"name":"German Cancer Consortium (DKTK) Partner Site University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl\u2010Heinz","family":"J\u00f6ckel","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, Biometry and Epidemiology University of Duisburg\u2010Essen Essen 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