**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.**
Foteini Theodorakakou, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece, foteint@gmail.com

**Main Body of the Abstract**
Background: Outcomes of patients with AL progressing to end-stage renal disease requiring dialysis is not well documented.
Objective: To report characteristics and outcomes of AL patients starting dialysis after initiation of primary therapy.
Methods: We analyzed data of 295 consecutive AL patients from three European centers which started dialysis >1 month from treatment initiation.
Results: Table 1 shows cohort’s characteristics. Median time from first-line therapy to dialysis was 19.8 months; 64(22%) patients started dialysis >5 years from diagnosis. In 33(11%) patients, dialysis was discontinued, 9(3%) underwent renal transplantation. At dialysis initiation, 59(20%) patients were in hemCR/VGPR, 43(15%) in hemPR and 60(20%) at hematologic relapse. After starting dialysis, 112(38%) patients received further therapy, due to hematologic relapse in 47(42%), inadequate response in 37(33%) and organ progression only in 26(23%), and 47(42%) achieved hemCR/VGPR, 17(21%) hemPR, while 42(38%) improved their response status. Median post-dialysis survival was 38 months, and has not improved in the more recent era. Heart involvement(p<0.001), BM plasma cells≥20%(p<0.001), less than hemCR/VGPR at dialysis(p=0.03) and dFLC≥50mg/L at dialysis (p=0.004) were associated with inferior post-dialysis survival in univariate analysis. Achieving ≥hemCR/VGPR in post-dialysis treatment was associated with better post-dialysis OS(p=0.011). Causes of death included disease progression in 89 (52%) patients, sepsis in 19(11%), cardiac-related in 23(13%), renal failure in 4(2%) and other/unknown in 37 (21%).
Conclusions: Patients with AL amyloidosis can have long post-dialysis survival and may benefit from further therapy; however, their management must be improved given new treatment options and renal transplantation option.



**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.**
Foteini Theodorakakou, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece, foteint@gmail.com

**Main Body of the Abstract**
**Background:** Outcomes of patients with AL progressing to end-stage renal disease requiring dialysis is not well documented.
**Objective:** To report characteristics and outcomes of AL patients starting dialysis after initiation of primary therapy.
**Methods:** We analyzed data of 295 consecutive AL patients from three European centers which started dialysis >1 month from treatment initiation.
**Results:** Table 1 shows cohort’s characteristics. Median time from first-line therapy to dialysis was 19.8 months; 64(22%) patients started dialysis >5 years from diagnosis. In 33(11%) patients, dialysis was discontinued, 9(3%) underwent renal transplantation. At dialysis initiation, 59(20%) patients were in hemCR/VGPR, 43(15%) in hemPR and 60(20%) at hematologic relapse. After starting dialysis, 112(38%) patients received further therapy, due to hematologic relapse in 47(42%), inadequate response in 37(33%) and organ progression only in 26(23%), and 47(42%) achieved hemCR/VGPR, 17(21%) hemPR, while 42(38%) improved their response status. Median post-dialysis survival was 38 months, and has not improved in the more recent era. Heart involvement(p<0.001), BM plasma cells≥20%(p<0.001), less than hemCR/VGPR at dialysis(p=0.03) and dFLC≥50mg/L at dialysis (p=0.004) were associated with inferior post-dialysis survival in univariate analysis. Achieving ≥hemCR/VGPR in post-dialysis treatment was associated with better post-dialysis OS(p=0.011). Causes of death included disease progression in 89 (52%) patients, sepsis in 19(11%), cardiac-related in 23(13%), renal failure in 4(2%) and other/unknown in 37 (21%).
**Conclusions:** Patients with AL amyloidosis can have long post-dialysis survival and may benefit from further therapy; however, their management must be improved given new treatment options and renal transplantation option.



Outcomes of patients with AL amyloidosis and end-stage renal disease after initiation of therapy OA16 (#501)

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.