Ashima Singh: Division of Hematology/Oncology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Aniko Szabo: Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. ORCID
Qinghua Lian: Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Liliana Pezzin: Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Rodney Sparapani: Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Anita D'Souza: Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. andsouza@mcw.edu. ORCID
It is well-established that most patients with systemic light chain (AL) amyloidosis have multi-organ involvement and are often diagnosed after a lag period of increasing symptoms. We leverage electronic health record (EHR) data from the TriNetX research network to describe the incidence, timing, and co-occurrence of precursor conditions of interests in a cohort of AL amyloidosis patients identified between October 2015-December 2020. Nineteen precursor diagnoses of interest representing features of AL amyloidosis were identified using ICD codes up to 36 months prior to AL amyloidosis diagnosis. Among 1,401 patients with at least 36 months of EHR data prior to AL amyloidosis diagnosis, 46% were females, 16% were non-Hispanic Black, and 6% were Hispanic. The median age was 71 (range, 21-91) years. The median number of precursor diagnoses was 5 with dyspnea and fatigue being the most prevalent. The time from the first occurrence of a precursor to AL diagnosis ranged from 3.2 to 21.4 months. Analyses of pairwise co-occurrence of specific diagnoses indicated a high association (Cole's coefficient >0.6) among the examined precursor diagnoses. These findings provide novel information about the timing and co-occurrence of key precursor conditions and could be used to develop algorithms for early identification of AL amyloidosis.
References
Blood Cancer J. 2021 Apr 10;11(4):72
[PMID: 33839739]
Blood Cancer J. 2023 Jan 25;13(1):19
[PMID: 36697388]
