**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.**
Eli Muchtar, Mayo Clinic, Rochedter, MN

**Main Body of the Abstract**
Introduction: Renal AL amyloidosis can be complicated by end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Renal staging based on 24-hour proteinuria and estimated glomerular filtration rate (Palladini, 2014) predicts the risk of progression to ESRD. Herein, we evaluated the utility of renal staging among patients undergoing autologous stem cell transplantation (ASCT)
Methods: Retrospective chart review of patients (n=697; Mayo Clinic, BU) with renal AL amyloidosis who underwent ASCT between 2003–2020. Renal stage was assigned at pre-ASCT timepoint. Patients who progressed to ESRD before ASCT were excluded. Renal survival was measured from the day of ASCT. Patients who did not progress to ESRD were censored, irrespective of life status.
Results: Pre-ASCT renal stage was I, II, and III in 35%, 52%, and 12% of patients, respectively. With a median follow-up of 10.4 years, RRT was initiated for 149 patients (21%). Pre-ASCT renal stage was significantly associated with renal survival: the 3-year RRT rate was 3%, 10%, and 37% for renal stage I, II, and III, respectively (Figure). The median time from ASCT to ESRD was 3.3 years. In multivariate analysis, renal survival was independently associated with the renal stage (hazard ratio [HR] 4.3 and 18.1 for stage II and III vs stage I, respectively); lambda isotype (HR 1.9); bone marrow plasma cell percentage ≥20% (HR 0.3); post-ASCT hematological response (higher HR with lower response); and ASCT era (HR 0.4 for 2012–2020 vs 2003–2011).
Conclusion: Renal stage reliably predicts renal outcomes in patients with AL undergoing ASCT.



**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.**
Eli Muchtar, Mayo Clinic, Rochedter, MN

**Main Body of the Abstract**
**Introduction**: Renal AL amyloidosis can be complicated by end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Renal staging based on 24-hour proteinuria and estimated glomerular filtration rate (Palladini, 2014) predicts the risk of progression to ESRD. Herein, we evaluated the utility of renal staging among patients undergoing autologous stem cell transplantation (ASCT)
**Methods**: Retrospective chart review of patients (n=697; Mayo Clinic, BU) with renal AL amyloidosis who underwent ASCT between 2003–2020. Renal stage was assigned at pre-ASCT timepoint. Patients who progressed to ESRD before ASCT were excluded. Renal survival was measured from the day of ASCT. Patients who did not progress to ESRD were censored, irrespective of life status.
**Results**: Pre-ASCT renal stage was I, II, and III in 35%, 52%, and 12% of patients, respectively. With a median follow-up of 10.4 years, RRT was initiated for 149 patients (21%). Pre-ASCT renal stage was significantly associated with renal survival: the 3-year RRT rate was 3%, 10%, and 37% for renal stage I, II, and III, respectively (Figure). The median time from ASCT to ESRD was 3.3 years. In multivariate analysis, renal survival was independently associated with the renal stage (hazard ratio [HR] 4.3 and 18.1 for stage II and III vs stage I, respectively); lambda isotype (HR 1.9); bone marrow plasma cell percentage ≥20% (HR 0.3); post-ASCT hematological response (higher HR with lower response); and ASCT era (HR 0.4 for 2012–2020 vs 2003–2011).
**Conclusion**: Renal stage reliably predicts renal outcomes in patients with AL undergoing ASCT.



Validating the performance of renal staging in AL amyloidosis patients undergoing autologous stem cell transplantation PA118 (#280)

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.