IMPACT OF THE CREATION OF A MULTIDISCIPLINARY GROUP FOR THE STUDY OF AMYLOIDOSES IN A DEVELOPING LATIN AMERICAN COUNTRY

Abstract

Background: Amyloidosis represent a diagnostic challenge, due to a low clinical suspicion and the technical difficulty involved in correct typing of amyloid. Recognition of the clinical picture is usually delayed, in part due to its multisystemic and nonspecific involvement. Moreover, treatments are mostly of high cost, which makes it a difficult disease to manage in developing countries. Objectives: The objective of this study was to evaluate the impact of the creation of an Amyloidoses multidisciplinary study group in a public center in a developing Latin American country, in terms of increasing diagnostic and improving correct classification, management and survival. Methods: An observational analytic ambispective cohort study was made. All patients in the amyloidosis registry of our center from 2005 to 2022 were included. We divided the cohort in 2 groups, period 1 (P1) that included years 2005 to 2014 (without amyloidosis study group), and period 2 (P2) that included years 2015 to 2022 (with amyloidosis study group). Results: Fifty-six patients with diagnosis of amyloidosis were included: 12 in P1 and 44 in P2. Classification according the “Mayo 2012”prognostic score was done in 8% of AL amyloidosis patients in P1 vs 40% in P2 (p = 0.035), and according to the “European prognostic score”in 8% vs 50% (p = 0.009), respectively. Early mortality rate was 67% in P1 and 30% in P2 (p = 0.020). The estimated 5-years overall survival (OS) of the whole cohort was 16.7% in P1 vs 43.6% in P2 (p = 0.017). Discussion: We were able to increase diagnosis by a 366%, and significantly improve classification and treatment in P2. Importantly, early mortality decreased, and OS was better. Conclusion: The creation of a multidisciplinary Amyloidosis study group improved diagnosis, classification, and outcomes of patients in a developing Latin American country.