title: Troponin T level as an exclusion criterion for stem cell transplantation in light-chain amyloidosis.
abstract: The efficacy of stem cell transplantation in amyloidosis largely is determined by treatment-related mortality rates (range, 11-25%). Appropriate patient selection is essential to avoid this high mortality rate. Among 271 patients undergoing stem cell transplantation, troponin T was a powerful predictor of treatment-related mortality. Patients with troponin T levels of 0.06 microg/L or higher had a day-100 all-cause mortality rate of 28%. Patients with troponin T levels less than 0.06 microg/L had a day-100 all-cause mortality rate of 7% (P < 0.001). Troponin T levels should be measured in all patients before transplantation. Those with troponin T levels exceeding 0.06 microg/L should be considered for less toxic therapies until the clinically optimal use of stem cell transplantation is better defined by randomized clinical trials.
authors.affiliation: Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. gertz.morie@mayo.edu
authors.forename: Morie
authors.initials: M
authors.lastname: Gertz
authors.forename: Martha
authors.initials: M
authors.lastname: Lacy
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hayman
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.forename: Mark
authors.initials: M
authors.lastname: Litzow
mesh_terms: D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D015415:Biomarkers; D002423:Cause of Death; D004562:Electrocardiography; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D007147:Immunoglobulin Light Chains; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains; D020107:Troponin T