**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Despina Fotiou
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece

**Main Body of the Abstract**
Introduction: Hemostatic abnormalities and deregulated coagulation are common complications in AL amyloidosis. The relevant risks of thromboembolic and hemorrhagic events have not been thoroughly evaluated. Methods/Aim: We performed a retrospective analysis in 450 consecutive newly-diagnosed patients with AL amyloidosis to describe clinically-significant thrombotic/hemorrhagic events. Results: VTE were reported in 6% and AEEs in 5% of patients respectively during a 55-month median follow-up. Out of 26 patients with VTE events, 18 were on anti-clonal treatment (9 on IMiDs). Lower albumin, lower eGFR, higher bone marrow infiltration, soft-tissue involvement, MiD-based therapy and prior thrombosis were associated with a higher VTE risk. A history of thrombosis was the only independent prognostic variable (HR 9.3, p=0.001, 95% CI 2.3-36.6).  With regards to AEE, a history of CAD, prior AEE, baseline proteinuria and higher platelet counts at diagnosis were associated with increased risk. The median time from diagnosis to VTE was 9.5 months (0.1 – 107) and to the AEE 14 months (0.62-114). Significant bleeding events were reported in 9% and associated mortality was 19%. Liver involvement, higher serum creatinine and higher baseline vWF:Ag levels were linked to bleeding risk. Using competing risk analysis, the cumulative probability of thrombosis /bleeding was higher during the first year following diagnosis but a stable lower risk for both events remained for the duration of follow-up. Conclusion: The risk of thrombotic/arterial embolic events in AL amyloidosis patients is significant but the bleeding risk is also high. Multiparametric assessment is required to initiate antithrombotic or antiplatelet therapy appropriately.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Despina Fotiou
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece

**Main Body of the Abstract**
**Introduction:** Hemostatic abnormalities and deregulated coagulation are common complications in AL amyloidosis. The relevant risks of thromboembolic and hemorrhagic events have not been thoroughly evaluated. **Methods/Aim**: We performed a retrospective analysis in 450 consecutive newly-diagnosed patients with AL amyloidosis to describe clinically-significant thrombotic/hemorrhagic events. **Results:** VTE were reported in 6% and AEEs in 5% of patients respectively during a 55-month median follow-up. Out of 26 patients with VTE events, 18 were on anti-clonal treatment (9 on IMiDs). Lower albumin, lower eGFR, higher bone marrow infiltration, soft-tissue involvement, MiD-based therapy and prior thrombosis were associated with a higher VTE risk. A history of thrombosis was the only independent prognostic variable (HR 9.3, p=0.001, 95% CI 2.3-36.6).  With regards to AEE, a history of CAD, prior AEE, baseline proteinuria and higher platelet counts at diagnosis were associated with increased risk. The median time from diagnosis to VTE was 9.5 months (0.1 – 107) and to the AEE 14 months (0.62-114). Significant bleeding events were reported in 9% and associated mortality was 19%. Liver involvement, higher serum creatinine and higher baseline vWF:Ag levels were linked to bleeding risk. Using competing risk analysis, the cumulative probability of thrombosis /bleeding was higher during the first year following diagnosis but a stable lower risk for both events remained for the duration of follow-up. **Conclusion:** The risk of thrombotic/arterial embolic events in AL amyloidosis patients is significant but the bleeding risk is also high. Multiparametric assessment is required to initiate antithrombotic or antiplatelet therapy appropriately.



Thrombotic and Bleeding complications in patients with AL Amyloidosis PA112 (#143)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.