Stratification of 1378 patients with AL amyloidosis according to the validated staging systems. (A) European modification of the Mayo Clinic 2004 staging system.^31,35 The staging system is based on NT-proBNP and cardiac troponin (cTn). Troponin I was used in this figure. Cutoffs are 332 ng/L for NT-proBNP and 100, 35, and 54 ng/L for cTnI, cTnT, and high-sensitivity cTnT, respectively. B-type natriuretic peptide can substitute for NT-proBNP in the staging system (cutoff, 81 ng/L).³⁶ Patients with stage I, II, and III have 0, 1, and 2 markers above the cutoff, respectively. Patients with stage III are classified as stage IIIa or IIIb according to concentration of NT-proBNP below or above 8500 ng/L. (B) Revised Mayo Clinic staging system.³⁷ The staging system is based on NT-proBNP, cTn, and dFLC. Cutoffs are 1800 ng/L for NT-proBNP and 25 ng/L for cTnT. Troponin I can substitute for cTnT (cutoff, 70 ng/L)³⁸ and was used in this figure. Patients with stage I, II, III, and IV have 0, 1, 2, and 3 markers above the cutoff, respectively. (C) Renal staging system.³⁹ The staging system is based on estimated glomerular filtration rate (eGFR) and proteinuria. Cutoffs are 50 mL/min per 1.73 m² for eGFR and 5 g/24 h for proteinuria. Patients with stage I, II, and III have 0, 1, and 2 markers above the cutoff, respectively.