**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.**
Dr. Aparna Hari
Amrita Vishwa Vidyapeetham
Department of Cardiology
Kochi, Kerala
aparnahari018@gmail.com

**Main Body of the Abstract**
Background - Systemic light chain amyloidosis (AL Amyloidosis) is characterized by the aberrant clonal proliferation and deposition of insoluble amyloid fibrils within the extracellular matrix across various organs. AL amyloidosis in low- and middle-income countries (LMIC) is underdiagnosed primarily due to insufficient training and a dearth of multidisciplinary collaboration. Moreover, clinical outcomes are adversely impacted by delays in diagnosis and therapy.

Methodology - This study analyses patient characteristics and outcomes from the Amrita Amyloid Cohort. Patients were recruited between 2005­—2023 in the Amrita Amyloid Centre, India’s first amyloid center. We use multiple imputations by chain equations to estimate quartiles for continuous characteristics and percentages with 95% CI for categorical characteristics.

Results – A total of 174 patients were included with a median age of 61 years and 77.9% were male. Patient characteristics and outcomes are shown in the Table. The most common mode of presentation was heart failure (64%). CyborD (Cyclophosphamide/ Bortezomib/Dexamethasone) was the most common induction regimen (57%). Advanced therapeutic options such as autologous stem cell transplant and CyborD/Daratumumab combination were used in 7 and 4 patients, respectively.

Conclusion - This study delineates the clinical course of AL amyloidosis patients in an LMIC setting. Given the lower survival rates compared to high-income countries, the findings underscore a need to improve detection and access to contemporary therapeutics in a resource-limited setting.  Adequate training in identifying red flags from low-cost diagnostic methods such as ECG and echo has the potential to detect cardiac involvement thus paving the way for therapy optimization.



**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.**
Dr. Aparna Hari
Amrita Vishwa Vidyapeetham
Department of Cardiology
Kochi, Kerala
aparnahari018@gmail.com

**Main Body of the Abstract**
**Background -** Systemic light chain amyloidosis (AL Amyloidosis) is characterized by the aberrant clonal proliferation and deposition of insoluble amyloid fibrils within the extracellular matrix across various organs. AL amyloidosis in low- and middle-income countries (LMIC) is underdiagnosed primarily due to insufficient training and a dearth of multidisciplinary collaboration. Moreover, clinical outcomes are adversely impacted by delays in diagnosis and therapy.

**Methodology -** This study analyses patient characteristics and outcomes from the Amrita Amyloid Cohort. Patients were recruited between 2005­—2023 in the Amrita Amyloid Centre, India’s first amyloid center. We use multiple imputations by chain equations to estimate quartiles for continuous characteristics and percentages with 95% CI for categorical characteristics.

**Results –** A total of 174 patients were included with a median age of 61 years and 77.9% were male. Patient characteristics and outcomes are shown in the Table. The most common mode of presentation was heart failure (64%). CyborD (Cyclophosphamide/ Bortezomib/Dexamethasone) was the most common induction regimen (57%). Advanced therapeutic options such as autologous stem cell transplant and CyborD/Daratumumab combination were used in 7 and 4 patients, respectively.

**Conclusion -** This study delineates the clinical course of AL amyloidosis patients in an LMIC setting. Given the lower survival rates compared to high-income countries, the findings underscore a need to improve detection and access to contemporary therapeutics in a resource-limited setting.  Adequate training in identifying red flags from low-cost diagnostic methods such as ECG and echo has the potential to detect cardiac involvement thus paving the way for therapy optimization.



Insights into Systemic AL Amyloidosis Care in India: A Retrospective Analysis from the Amrita Amyloid Centre PA157 (#266)

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.