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©2013 UpToDate ® Print Email Prognostic staging systems for amyloidosis Prognostic model Risk groups Survival in patients not undergoing stem cell transplantation Survival in patients undergoing stem cell transplantation Median in months Five-year survival rate (percent)* Median in months Four-year survival rate (percent)* Mayo stage [1,2] Stage I Cardiac troponin <0.035 mcg/L and NT-proBNP <332 ng/L 26 28 Not reached at 40 months 85 • Stage II Any one factor high 11 12 Not reached at 40 months 75 • Stage III Cardiac troponin ≥0.035 mcg/L and NT-proBNP ≥332 ng/L 4 8 8 25 • Revised Mayo stage [3] Stage I NT-pro-BNP <1800 ng/L, cardiac troponin T <0.025 mcg/L, and difference between involved and uninvolved serum free light chains <18 mg/dL 55 50 Not reached 87 Stage II Any one factor high 19 35 97 72 Stage III Any two factors high 12 20 58 56 Stage IV NT-pro-BNP ≥1800 ng/L, cardiac troponin T ≥0.025 mcg/L, and difference between involved and uninvolved serum free light chains ≥18 mg/dL 5 15 22 46 * Estimated from published survival curve if not reported. • Survival rate at 40 months. References: Dispenzieri A, Gertz MA, Kyle RA, et al. Serum cardiac troponins and N-terminal pro-brain natriuretic peptide: a staging system for primary systemic amyloidosis. J Clin Oncol 2004; 22:3751. Dispenzieri A, Gertz MA, Kyle RA, et al. Prognostication of survival using cardiac troponins and N-terminal pro-brain natriuretic peptide in patients with primary systemic amyloidosis undergoing peripheral blood stem cell transplantation. Blood 2004; 104:1881. Kumar S, Dispenzieri A, Lacy MQ, et al. Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements. J Clin Oncol 2012; 30:989.