What are the limitations of the al amyloidosis staging?

While the al amyloidosis staging is highly validated, it should not replace clinical judgment. OpiCalc provides the latest evidence-based limitations for the al amyloidosis staging to ensure safe bedside use and optimal diagnostic accuracy.

How does the al amyloidosis staging compare to other Hematology scores?

The al amyloidosis staging is a gold-standard diagnostic tool. OpiCalc provides side-by-side clinical guidance to help clinicians choose the most specific evidence-based tool for their patient's presentation.

Is the al amyloidosis staging free to use?

Yes. OpiCalc provides the al amyloidosis staging completely ad-free and optimized for mobile bedside use, ensuring you can calculate medical risk swiftly and without distraction.

OpiCalc

935 Clinical Tools

OpiCalc

4Ts Score (HIT)aaIPI (Age-adjusted IPI)ABC Score (Massive Transfusion)Absolute Neutrophil Count Age-adjusted D-dimer Threshold aGvHD Grading (Glucksberg/MAGIC)AL Amyloidosis Staging (Mayo)Anti-Xa Monitoring Interpreter Antiphospholipid Syndrome Classification Binet / Rai Staging (CML)Blood Volume Calculator Caprini VTE Risk CISNE Score CLL-IPI Coombs-Negative Haemolysis Checklist Corrected Reticulocyte Count CRS Grading (ASTCT 2019)DAT Interpretation Algorithm Deauville Score Interpreter DIC Score (ISTH)DIPSS (MF)DIPSS-Plus (MF)DOAC Dose Selector DOAC Renal Dose Adjustment DRI (Disease Risk Index)Durie-Salmon Staging (historical)EBMT Risk Score ELN 2022 AML Risk Classification ELTS Score (CML)England & Fraser Index EUTOS Score (CML)Expected Hb Rise per RBC Unit Factor Inhibitor Bethesda Titre Interpreter Febrile Neutropaenia Risk (MASCC)Fibrinogen Replacement FLIPI (Follicular Lymphoma IPI)FLIPI-2 French TTP Score GAPSS (Global APS Score)Haemophilia Severity Classification HbS Percentage Target Calculator HCT-CI (Comorbidity Index)HEP Score Heparin Nomogram (Weight-based)Hepatic Iron Index HERDOO2 Rule HFE Haemochromatosis Risk Estimator ICANS Grading (ASTCT 2019)IMWG Response Criteria (Myeloma)IPI (International Prognostic Index)IPSID / Lugano Classification IPSS-M (Molecular IPSS)IPSS-R (Revised IPSS for MDS)Iron Deficit Calculator (Ganzoni Formula)ISS (Myeloma)ISTH Bleeding Assessment Tool (BAT)ISTH Non-Overt DIC Score ITP Bleeding Score iwCLL Response Criteria (2018)IWG ITP Response Criteria JAK2V617F Allele Burden Interpreter Karnofsky Performance Scale Leucostasis Risk Threshold Lupus Anticoagulant (LAC) Reporting Framework MAGIC aGvHD Biomarker Score MCV-based Anaemia Algorithm Mentzer Index MIPI (MCL IPI)MIPSS70+ v2.0 (MF)Mixing Study Interpretation MRD Assessment Threshold Interpreter mSMART 3.0 (Myeloma)MTP Activation Criteria NCCN-IPI NIH Chronic GvHD Scoring NTDT Iron Burden Estimator Padua RAM PBT (Paediatric BAT)PCNSL MSKCC Score PERC Rule Perioperative Anticoagulation Bridging PESI Score (PE Mortality)PLASMIC Score Platelet Increment Calculator (CCI)PNH Clone Size Interpreter R-IPI (Revised IPI)R-ISS (Revised ISS)Reticulocyte Index (RPI)Revised Geneva Score (PE)Revised Response Criteria (NHL)Revised Zubrod / ECOG Performance Shine & Lal Index Sickle Cell Disease Risk (TCD)SLiM-CRAB Criteria SOKAL Score (CML)Sokal/EUTOS/ELTS Comparison sPESI (Simplified PESI)TACO Risk Score Thalassaemia Transfusion Threshold Thrombocytopaenia Differential Thrombophilia Screening Eligibility Algorithm Time in Therapeutic Range (TTR)TLS Risk Classification Transferrin Saturation Calculator Vienna Prediction Model von Willebrand Factor Activity Interpreter Warfarin Dose Calculator Wells Score (DVT)Wells Score (PE)WHO 2022 AML Classification Mapper WHO Bleeding Scale YEARS Algorithm

AL Amyloidosis Staging (Mayo)

Mayo 2012 AL Staging: Risk stratification based on Troponin, NT-proBNP, and dFLC. High thresholds reflect significant organ/clone burden.

Calculated Amyloid Stage

I

Median Overall Survival

94 mo

Early stage disease. Favorable candidates for autologous stem cell transplant if other fitness criteria met.

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Prognostic staging of patients with systemic light-chain (AL) amyloidosis.

Predicting overall survival (OS) based on cardiac biomarkers and light chain burden.

Guiding treatment intensity (especially the decision for autologous stem cell transplant).

Patient Population

Patients with biopsy-proven AL amyloidosis.

When Not to Rely on This Score Alone

Transthyretin (ATTR) Amyloidosis — use the Gillmore/UCL staging instead.

Renal stage — the Mayo 2012 score focuses on survival (driven by cardiac status); for predicting risk of dialysis, use the Palladini Renal Staging (proteinuria + eGFR).

Section 2

Formula & Logic

Thresholds (+1 point for each above)

Biomarker	Threshold
NT-proBNP	≥ 1800 pg/mL
Cardiac Troponin T	≥ 0.025 ng/mL (or Trop I ≥ 0.1)
dFLC (involved − uninvolved)	≥ 18 mg/dL (180 mg/L)

Risk Groups

Points	Stage	Median OS (Months)
0	Stage I	94
1	Stage II	40
2	Stage III	14
3	Stage IV	5.8

Section 3

Pearls/Pitfalls

The dFLC Factor

The difference between involved and uninvolved free light chains (dFLC) is a better predictor of outcome in amyloidosis than the FLC ratio itself, as it more accurately reflects the clone's proteolytic/amyloidogenic potential.

Section 4

Evidence Appraisal

Primary Score

Revised prognostic staging system for light chain amyloidosis incorporating cardiac biomarkers and serum free light chain measurements.

Kumar S et al. • Journal of Clinical Oncology. 2012;30(9):989-95.

View Source

Section 5

Literature

Update

The 2012 Revised Mayo Staging updated the original 2004 system (which used only NT-proBNP and Troponin) by adding the dFLC, providing better discrimination for the most high-risk patients.

Last Comprehensive Review: 2026

Related Hematology Tools

iwCLL Response Criteria

Revised Response Criteria

PCNSL MSKCC Score

ISS

R-ISS

IMWG Response Criteria

MRD Assessment Threshold Interpreter

mSMART 3.0

SLiM-CRAB Criteria

Durie-Salmon Staging

Have feedback about this calculator?Let us know.