Treatment Patterns and Clinical Outcomes of Patients With Systemic Light Chain Amyloidosis in the United States: Evidence From Real-World Clinical Practice
Bibliographic record
Abstract
BACKGROUND: This study described real-world treatment patterns and outcomes in patients with systemic light chain (AL) amyloidosis in the United States (US). METHODS: De-identified chart review data were obtained from 117 adult patients diagnosed with systemic AL amyloidosis (01/01/2014-12/31/2021) who initiated 1 L treatment, outside of a clinical trial setting, on or after January 1, 2014, and received ≥ 1 treatment at a US medical center. RESULTS: Among patients, (median age: 63.2 years; female: 50.4%; White: 73.5%; Black/African American: 14.5%), most patients received 2 or more lines of treatment (62.4%) with 30.8% receiving 2 lines of treatment, predominantly cyclophosphamide, bortezomib, and dexamethasone (CyBorD)-, daratumumab-, and dexamethasone-based regimens. In first-line, one third of patients had hematologic response (complete response [CR]: 31.6%; very good partial response (29.1%); for later lines, CR rates tended to decrease. By 57.5 months, ≥60% of patients were still alive (Kaplan-Meier rates - 12 months: 92.0%; 24 months: 84.4%). Median progression-free survival (41.4 months), event-free survival (24.4 months), and time to next treatment (43.2 months) were unexpectedly longest in second line. CONCLUSIONS: The study demonstrated that there was heterogeneity in the treatment of AL amyloidosis, and patients who receive treatment can survive for several years after diagnosis without progression.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".