AL amyloidosis is staged using biomarkers — substances measured in your blood that show how well your heart and other organs are working. The most widely used system is the Mayo Clinic Staging System, which looks at three key markers:
- NT-proBNP — rises when the heart is under stress
- Cardiac troponin T (cTnT) — signals Show Full Answer
AL amyloidosis is staged using biomarkers — substances measured in your blood that show how well your heart and other organs are working. The most widely used system is the Mayo Clinic Staging System, which looks at three key markers:
- NT-proBNP — rises when the heart is under stress
- Cardiac troponin T (cTnT) — signals heart muscle damage
- dFLC — measures how many abnormal light-chain proteins are present
The number of elevated markers determines your stage. Here's how the Mayo Clinic stages break down, along with average survival estimates:
- Stage 1 — All three markers are normal. Average survival: ~9.8 years
- Stage 2 — One marker is elevated. Average survival: ~6.3 years
- Stage 3 — Two markers are elevated. Average survival: ~5.3 years
- Stage 4 — All three markers are elevated. Average survival: ~2.3 years
These are averages, not guarantees — many people do better than the numbers suggest, especially with newer treatments. Some doctors use a modified version called the European Modification, which splits Stage 3 into two subgroups:
- Stage 3A — Both heart markers are elevated, but NT-proBNP is below 8,500 nanograms per liter
- Stage 3B — Both markers are elevated, and NT-proBNP is above 8,500 nanograms per liter
Stage 3B is generally associated with a more serious outlook and may call for more urgent treatment decisions. It's worth knowing that staging isn't a fixed label — it can change as treatment progresses. If biomarker levels improve with treatment, that's a positive sign. Talking with your care team about your specific numbers can help you better understand where things stand and what options make sense for you.
August 19
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