Authors
Muayad Azzam, Hassan Kawtharany, Jamil Nazzal, Qais Hamarsha, Aseel Alkhader, Tala Khraise, Mohammad M AlMasri, Hadi K Abou Zeid, Iktimal Alwan, Nour Jaber, Maria Adela Aguirre, Deborah Boedicker, Naresh Bumma, Antonia S Carroll, Raymond Comenzo, Joselle Cook, Noel R Dasgupta, Alfredo De La Torre, Angela Dispenzieri, Faizi Jamal, Jack Khouri, Nelson Leung, Maria M Picken, Shahzad Raza, Vaishali Sanchorawala, Nitasha Sarswat, Hira Shaikh, Daulath Singh, Matthew D Seftel, Vishal Kukreti, Reem A Mustafa
Published in
Blood advances. Sep 04, 2026. Epub Sep 04, 2026.
Abstract
In this systematic review, we aimed to assess the diagnostic test accuracy (DTA) of abdominal fat pad sampling and bone marrow biopsy for immunoglobulin light-chain (AL) amyloidosis using organ biopsy as the reference standard. We searched the literature using PubMed, Embase, and CENTRAL databases from inception through March 2024. We used QUADAS-2 to assess the risk of bias and the GRADE approach to assess the certainty of evidence (COE). After deduplication, 29,237 records were screened, and 31 studies were included. Twenty-five studies (n=4,649) reported on fat pad sampling, with a pooled sensitivity of 0.77 (95%CI 0.72-0.81), while twenty studies (n=2,771) reported on bone marrow biopsy, with a pooled sensitivity of 0.55 (0.46-0.63). All studies enrolled patients with confirmed disease, specificity was not reported in the included studies. Fat pad aspiration (15 studies, n=1,590) and surgical or punch biopsy (4 studies, n=222) showed similar sensitivities of 0.80 (0.76-0.83) and 0.77 (0.61-0.88), respectively. In a single study (n=612), performing both tests together yielded a sensitivity of 0.89. COE was judged to be Moderate for fat pad sampling and Low for bone marrow biopsy.
PMID:
42696041
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.
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