**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.**
Meletios A. Dimopoulos, Department of Clinical Therapeutics, National and Kapodistrian University of Athens Medical School, Athens, Greece, mdimop@med.uoa.gr

**Main Body of the Abstract**
Background: In AL amyloidosis, sustained long-term hematologic remission can be achieved even with conventional therapies.
Aim: To identify clinical characteristics that are associated with long-term hematologic remission ≥5 years, without the use of ASCT.
Methods: We analyzed 210 consecutive patients with AL, treated without ASCT, with ≥5 years of follow-up, excluding patients who survived <6 months and focusing on patients who: had not had hematologic PD, not received salvage therapy, were still alive or had died from causes unrelated to AL.
Results: Long-term hematologic remission rate was 17%(n=35); clinical characteristics are shown in the Table. Median duration of primary therapy was 7.5(4-21) months vs 5.6(0.5-21) for patients without long-term remission (p<0.001); for patients that received lenalidomide was 9.7(5-12) vs 7.1(0.5-17) months (p=0.023). Hematologic response to 1st line therapy was ≥VGPR in 33(94%) patients (CR:22, VGPR:11) vs 46%(p<0.001), was ≥VGPR with dFLC<10mg/L in 18(51%) vs 20%(p<0.001) while 6(17%) had only low dFLC VGPR. At 1- and 3-month landmarks, 24(68%) and 27(77%) of those in long-term remissions had achieved ≥VGPR (vs 43(33%) and 62(46%),p<0.001). MRD (available in 19 patients) was undetectable in 11(31%) [vs 3(2%) of the non-sustained remission group,p<0.001]. Cardiac response was observed in 9/19(47%) patients and renal response in 18/30(60%); however, 7(20%) initiated dialysis despite deep hematologic responses.
Conclusion:Early, profoundly deep hematologic responses and prolonged therapy seem to be associated with long-term remissions using conventional therapies only. These data also underscore the role of prolonged therapies in which lenalidomide may be important as part of a maintenance strategy.



**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.**
Meletios A. Dimopoulos, Department of Clinical Therapeutics, National and Kapodistrian University of Athens Medical School, Athens, Greece, mdimop@med.uoa.gr

**Main Body of the Abstract**
**Background:** In AL amyloidosis, sustained long-term hematologic remission can be achieved even with conventional therapies.
**Aim:** To identify clinical characteristics that are associated with long-term hematologic remission ≥5 years, without the use of ASCT.
**Methods:** We analyzed 210 consecutive patients with AL, treated without ASCT, with ≥5 years of follow-up, excluding patients who survived <6 months and focusing on patients who: had not had hematologic PD, not received salvage therapy, were still alive or had died from causes unrelated to AL.
**Results:** Long-term hematologic remission rate was 17%(n=35); clinical characteristics are shown in the Table. Median duration of primary therapy was 7.5(4-21) months vs 5.6(0.5-21) for patients without long-term remission (p<0.001); for patients that received lenalidomide was 9.7(5-12) vs 7.1(0.5-17) months (p=0.023). Hematologic response to 1st line therapy was ≥VGPR in 33(94%) patients (CR:22, VGPR:11) vs 46%(p<0.001), was ≥VGPR with dFLC<10mg/L in 18(51%) vs 20%(p<0.001) while 6(17%) had only low dFLC VGPR. At 1- and 3-month landmarks, 24(68%) and 27(77%) of those in long-term remissions had achieved ≥VGPR (vs 43(33%) and 62(46%),p<0.001). MRD (available in 19 patients) was undetectable in 11(31%) [vs 3(2%) of the non-sustained remission group,p<0.001]. Cardiac response was observed in 9/19(47%) patients and renal response in 18/30(60%); however, 7(20%) initiated dialysis despite deep hematologic responses.
**Conclusion:**Early, profoundly deep hematologic responses and prolonged therapy seem to be associated with long-term remissions using conventional therapies only. These data also underscore the role of prolonged therapies in which lenalidomide may be important as part of a maintenance strategy.



Long-term hematologic remission in Immunoglobulin Light Chain (AL) Amyloidosis PA127 (#392)

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.