Table 3 Proportion of patients with precursor diagnoses based on time before AL amyloidosis diagnosis.
From: Timing and co-occurrence of symptoms prior to a diagnosis of light chain (AL) amyloidosis
Precursor diagnosis | Incidence within 2 years pre-AL amyloidosis (95% CI) | Prevalence at AL amyloidosis diagnosis (95% CI) | Median time to precursor before AL diagnosis, months (IQR) |
|---|---|---|---|
Clonal | |||
MGUS | 9% (17–21%) | 13% (11–15%) | 3.2 (0.6, 8.2) |
Smoldering multiple myeloma | 9% (8–11%) | 17% (15–19%) | 2.9 (0.5, 10.0) |
Cardiac | |||
Dyspnea | 34% (31–36%) | 55% (53–58%) | 8.1 (2.7, 15.9) |
Heart failure | 24% (22–26%) | 36% (34–39%) | 4.1 (1.2, 11.7) |
Arrhythmia | 19% (17–21%) | 34% (31–36%) | 7.5 (1.8, 16.7) |
Cardiomegaly | 19% (17–21%) | 24% (22–26%) | 5.2 (0.9, 13.7) |
Cardiomyopathy | 12% (10–13%) | 17% (15–19%) | 3.9 (1.0, 11.2) |
Renal | |||
Acute kidney injury | 22% (20–24%) | 29% (26–31%) | 4.8 (1.3, 12.6) |
Renal disease | 22% (20–24%) | 38% (35–40%) | 5.2 (1.2, 12.7) |
Proteinuria | 10% (9–12%) | 14% (12–16%) | 3.3 (0.8, 10.8) |
Nephritic syndrome | 2% (1–3%) | 2% (1.5–3%) | 1.2 (0.1, 8.6) |
Nephrotic syndrome | 1% (0.7–2%) | 2% (1.5–3%) | 8.8 (4.2, 15.8) |
Gastrointestinal | |||
Altered bowels | 26% (24–29%) | 37% (35–40%) | 6.7 (1.5, 14.9) |
Abdominal pain | 23% (21–26%) | 33% (30–35%) | 7.4 (1.4, 15.4) |
Nausea and/or vomiting | 19% (17–21%) | 25% (23–27%) | 6.4 (1.1, 15.8) |
Dysphagia | 10% (8–11%) | 13% (11–15%) | 5.0 (0.8, 13.9) |
Hepatomegaly and/or splenomegaly | 4% (3–5%) | 5% (4–6%) | 3.3 (0.7, 11.9) |
Neurologic | |||
Neuropathy | 25% (22–27%) | 40% (37–43%) | 8.5 (1.8, 15.7) |
Autonomic neuropathy | 1% (0.2–1%) | 1% (0.4–1.4%) | 3.0 (0.4, 12.9) |
Multisystemic | |||
Edema | 27% (24–29%) | 37% (34–39%) | 6.3 (1.2, 14.9) |
Dizziness | 17% (15–19%) | 24% (21–26%) | 7.8 (1.7, 15.5) |
Pleural effusion | 15% (13–17%) | 18% (16–20%) | 2.9 (0.6, 8.1) |
Syncope | 11% (10–13%) | 15% (13–17%) | 4.7 (1.0, 13.0) |
Orthostatic hypotension | 8% (7–9%) | 11% (9–39%) | 6.9 (1.9, 16.9) |
Ascites | 5% (3–6%) | 5% (4–6%) | 2.7 (0.5, 8.4) |
Other | |||
Fatigue | 30% (28–33%) | 45% (42–47%) | 7.8 (1.9, 15.8) |
Carpal tunnel syndrome | 6% (5–7%) | 10% (8–35%) | 6.7 (1.8, 15.1) |
Purpura | 2% (1–3%) | 2% (2–3%) | 7.2 (0.8, 13.2) |
Macroglossia | 0.14% (NA, 0.3%) | 0.2% (NA, 0.5%) | 6.8 (3.8, 9.8) |
