Tags

Type your tag names separated by a space and hit enter

Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis.
J Clin Oncol. 2004 Sep 15; 22(18):3751-7.JC

Abstract

PURPOSE

Primary systemic amyloidosis (AL) is a multisystemic disorder resulting from an underlying plasma cell dyscrasia. There is no formal staging system for AL, making comparisons between studies and treatment centers difficult. Our group previously identified elevated serum cardiac troponin T (cTnT) as the most powerful predictor of overall survival. Others have reported that N-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable prognostic marker. We sought to develop a staging system for patients with AL.

PATIENTS AND METHODS

Two hundred forty-two patients with newly diagnosed AL who were seen at the Mayo Clinic between April 1979 and November 2000, and who had echocardiograms and stored serum samples at presentation were eligible for this retrospective review. NT-proBNP measurements were performed on 242 patients in whom cTnT and cardiac troponin I (cTnI) had been previously run. Two prognostic models were designed using threshold values of NT-proBNP and either cTnT or cTnI (NT-proBNP < 332 ng/L, cTnT < 0.035 microg/L, and cTnI < 0.1 microg/L). Depending on whether NT-proBNP and troponin levels were both low, were high for only one level, or were both high, patients were classified as stage I, II, or III, respectively.

RESULTS

Using the cTnT+NT-proBNP model 33%, 30%, and 37% of patients were stages I, II, and III, respectively, with median survivals of 26.4, 10.5, and 3.5 months, respectively. The alternate cTnI+NT-proBNP model predicted median survivals of 27.2, 11.1, and 4.1 months, respectively.

CONCLUSION

Stratification of AL patients into three stages is possible with two readily available and reproducible tests setting the stage for more consistent and reliable cross comparisons of therapeutic outcomes.

Authors+Show Affiliations

Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA. dispenzieri.angela@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15365071

Citation

Dispenzieri, Angela, et al. "Serum Cardiac Troponins and N-terminal Pro-brain Natriuretic Peptide: a Staging System for Primary Systemic Amyloidosis." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 22, no. 18, 2004, pp. 3751-7.
Dispenzieri A, Gertz MA, Kyle RA, et al. Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. J Clin Oncol. 2004;22(18):3751-7.
Dispenzieri, A., Gertz, M. A., Kyle, R. A., Lacy, M. Q., Burritt, M. F., Therneau, T. M., Greipp, P. R., Witzig, T. E., Lust, J. A., Rajkumar, S. V., Fonseca, R., Zeldenrust, S. R., McGregor, C. G., & Jaffe, A. S. (2004). Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 22(18), 3751-7.
Dispenzieri A, et al. Serum Cardiac Troponins and N-terminal Pro-brain Natriuretic Peptide: a Staging System for Primary Systemic Amyloidosis. J Clin Oncol. 2004 Sep 15;22(18):3751-7. PubMed PMID: 15365071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. AU - Dispenzieri,Angela, AU - Gertz,Morie A, AU - Kyle,Robert A, AU - Lacy,Martha Q, AU - Burritt,Mary F, AU - Therneau,Terry M, AU - Greipp,Philip R, AU - Witzig,Thomas E, AU - Lust,John A, AU - Rajkumar,S Vincent, AU - Fonseca,Rafael, AU - Zeldenrust,Steven R, AU - McGregor,Christopher G A, AU - Jaffe,Allan S, PY - 2004/9/15/pubmed PY - 2004/10/8/medline PY - 2004/9/15/entrez SP - 3751 EP - 7 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 22 IS - 18 N2 - PURPOSE: Primary systemic amyloidosis (AL) is a multisystemic disorder resulting from an underlying plasma cell dyscrasia. There is no formal staging system for AL, making comparisons between studies and treatment centers difficult. Our group previously identified elevated serum cardiac troponin T (cTnT) as the most powerful predictor of overall survival. Others have reported that N-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable prognostic marker. We sought to develop a staging system for patients with AL. PATIENTS AND METHODS: Two hundred forty-two patients with newly diagnosed AL who were seen at the Mayo Clinic between April 1979 and November 2000, and who had echocardiograms and stored serum samples at presentation were eligible for this retrospective review. NT-proBNP measurements were performed on 242 patients in whom cTnT and cardiac troponin I (cTnI) had been previously run. Two prognostic models were designed using threshold values of NT-proBNP and either cTnT or cTnI (NT-proBNP < 332 ng/L, cTnT < 0.035 microg/L, and cTnI < 0.1 microg/L). Depending on whether NT-proBNP and troponin levels were both low, were high for only one level, or were both high, patients were classified as stage I, II, or III, respectively. RESULTS: Using the cTnT+NT-proBNP model 33%, 30%, and 37% of patients were stages I, II, and III, respectively, with median survivals of 26.4, 10.5, and 3.5 months, respectively. The alternate cTnI+NT-proBNP model predicted median survivals of 27.2, 11.1, and 4.1 months, respectively. CONCLUSION: Stratification of AL patients into three stages is possible with two readily available and reproducible tests setting the stage for more consistent and reliable cross comparisons of therapeutic outcomes. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/15365071/Serum_cardiac_troponins_and_N_terminal_pro_brain_natriuretic_peptide:_a_staging_system_for_primary_systemic_amyloidosis_ L2 - https://ascopubs.org/doi/10.1200/JCO.2004.03.029?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -