Photo Credit: Jose Luis Calvo Martin & Jose Enrique Garcia-Maurino Muzquiz

Biomarker-based screening enabled early detection of pre-symptomatic light chain (AL) amyloidosis in patients with monoclonal gammopathy of undetermined significance (MGUS), according to a correspondence published in the American Journal of Hematology. The researchers conducted a longitudinal study of 4,742 patients at a single center. Over a median follow-up of 4 years, 1,375 patients (28.9%) with altered free light chain ratios underwent sequential monitoring for cardiac (NT-proBNP), renal (24-hour proteinuria), and hepatic (ALP) dysfunction. AL amyloidosis was diagnosed pre-symptomatically in 22 patients (1.6%; 2.5 per 1,000 person-years). Early detection allowed timely therapy, resulting in significant hematologic responses (73% overall; 18% complete) and organ recovery, including improved cardiac outcomes. None of the patients with normal biomarkers progressed to amyloidosis. The authors called for further validation in larger, multicenter studies but emphasized the value of integrating biomarker surveillance into follow-up for patients with MGUS to improve early diagnosis, therapeutic effectiveness, and patient outcomes.