Stages

Staging is a way to describe how serious AL amyloidosis is. It also helps your healthcare team know your outlook, also called prognosis. But it doesn't tell you exactly what will happen. Staging helps your healthcare team plan the right treatment for you.

There are several staging systems available to tell how AL amyloidosis may affect a person over time. These systems use blood test results that show stress or damage to the heart, such as troponin and NT-proBNP. Some also use results from echocardiograms.

Older AL amyloidosis staging systems include the Mayo 2012 system and the European-modified Mayo 2004 system. They group AL amyloidosis from stage 1 through stage 4. Stage 1 means earlier disease. Stage 4 means more-serious disease.

A newer system is the AL International Staging System (AL-ISS). It was created using information from people who received newer treatments. It groups AL amyloidosis from stage 1 through stage 3C. Stage 1 means earlier disease. Stage 3 means more-serious disease.

Staging systems continue to evolve as treatments improve. Your healthcare team can explain which system it uses and what your stage means for you.

The stage is only one part of your care. Your symptoms and other test results matter too. How well you do with treatment also matters.

01/09/2026
  1. Kukreti V, et al. American Society of Hematology 2026 guidelines on diagnosis of light chain amyloidosis. Blood Advances. 2026; doi:10.1182/bloodadvances.2025017073.
  2. Gertz MA. Immunoglobulin light chain amyloidosis: 2026 update on diagnosis, prognosis, and treatment. American Journal of Hematology. 2026; doi:10.1002/ajh.70246.
  3. Kumar SK, et al. Systemic light chain amyloidosis, version 2.2023. Journal of the National Comprehensive Cancer Network. 2023; doi:10.6004/jnccn.2023.0001.
  4. Hughes MS, et al. Primary systemic amyloidosis: A brief overview. La Presse Médicale. 2025; doi:10.1016/j.lpm.2024.104267.
  5. Daratumumab; hyaluronidase. Elsevier Drug Information. https://www.clinicalkey.com. Accessed Aug. 7, 2026.
  6. Wu X, et al. Systemic amyloid light-chain amyloidosis beyond ANDROMEDA: Diagnostic challenges and therapeutic updates. CA: A Cancer Journal for Clinicians. 2026; doi:10.3322/caac.70092.
  7. Cook J, et al. Clinical features of systemic amyloidosis: A scoping review. Blood Advances. 2026; doi:10.1182/bloodadvances.2025017237.
  8. Gertz MA, et al. Immunoglobulin light-chain amyloidosis (primary amyloidosis). In: Hematology: Basic Principles and Practice. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Aug. 7, 2026.
  9. Ferri FF. Amyloidosis. In: Ferri's Clinical Advisor 2026. Elsevier; 2026. https://www.clinicalkey.com. Accessed Aug. 7, 2026.
  10. Murphy JG, et al., eds. Mayo Clinic Cardiology: Concise Textbook. 5th ed. Oxford University Press; 2024. https://academic.oup.com. Accessed Aug. 7, 2026.
  11. Amyloidosis: Laboratory approach to diagnosis. https://www.mayocliniclabs.com. Mayo Clinic Laboratories; 2024.
  12. AskMayoExpert. Suspicion of systemic amyloidosis. Mayo Clinic; 2023.
  13. AL amyloidosis quick reference guide. American Heart Association. https://www.heart.org/en/professional/quality-improvement/al-amyloidosis. Accessed Aug. 7, 2026.
  14. Symptoms and diagnosis of cardiomyopathy. American Heart Association. https://www.heart.org/en/health-topics/cardiomyopathy/symptoms-and-diagnosis-of-cardiomyopathy. Accessed Aug. 7, 2026.
  15. Autologous stem cell transplant. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/autologous-stem-cell-transplant/pyc-20384859. Accessed Aug. 8, 2026.
  16. Bloom MW, et al. Cardiac amyloidosis. Annals of Internal Medicine. 2023; doi:10.7326/AITC202303210.
  17. NT-Pro B-type natriuretic peptide, serum. Mayo Clinic Laboratories. https://www.mayocliniclabs.com/test-catalog/overview/615897#clinical-and-interpretive. Accessed Aug. 5, 2026.
  18. Troponin T, 5th generation, plasma. Mayo Clinic Laboratories. https://www.mayocliniclabs.com/test-catalog/overview/65832/troponin-t-5th-generation-plasma#clinical-and-interpretive. Accessed Aug. 5, 2026.
  19. Medical review (expert opinion). Mayo Clinic. Aug. 24, 2026.
  20. Fontana M, et al. The last decade in cardiac amyloidosis: Advances in understanding pathophysiology, diagnosis and quantification, prognosis, treatment strategies, and monitoring response. JACC: Cardiovascular Imaging. 2025; doi:10.1016/j.jcmg.2024.10.011.