EHA 2025 | The impact of ethnicity on the risk stratification of systemic AL amyloidosis

Ethnicity is not very well reported across different countries because different countries use different criteria to report their ethnicity and we know from cardiac heart failure patients in the non-amyloid setting that ethnicity does impact certain parameters in heart failure. So NT-proBNP processing in patients with heart failure is different amongst black patients compared to white patients. And we looked at this in our UK cohorts we had you know over a thousand patients where we do record ethnicity kind of systematically and found there were differences in presenting NT-proBNP despite similar global longitudinal strains. So this definitely is an indication of a potential difference in how we may risk stratify in the current practice. I think our staging systems are not sophisticated enough really to kind of incorporate ethnicity as a part of the models. But I think certainly data from the UK show that we’ve published in over a thousand patients show that there are differences in cardiac biomarkers amongst ethnicities. And potentially, if we’re staging patients by these cardiac biomarkers, we may be inappropriately staging patients and giving them kind of potentially different ideas of prognosis that may not be relevant according to their ethnicity. So we’ve looked at this in the UK, there’s been some data in the US and I think what would be useful for the future is to kind of collaborate globally to see is this universally seen amongst different ethnicities and how can we make the staging prognostication a little bit more sophisticated to account for these differences.

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