Choy, Chern HsiangKwok, Chun ShingWahid, YasminLiu, BoyangTurvey-Haigh, LaurenParker, KennethCullis, JamesParekh, PoonamHussain, KhalidAkhtar, AkshannaBradlow, William MZaphiriou, AlexBaig, ShanatGillmore, Julian DFontana, MariannaPinney, JenniferSteeds, Richard PMoody, William E2025-11-142025-11-142025-10-07Jones E, Ewing J, Hussein H, Maybury B, Raghavan M, Suhr J, Duncan N. An evaluation of a real-world, multi-disciplinary, treatment-free remission programme for patients with Chronic Myeloid Leukaemia. J Oncol Pharm Pract. 2025 Oct 9:10781552251384611. doi: 10.1177/107815522513846112772-963X10.1016/j.jacadv.2025.10223041128711S2772-963X(25)00658-1https://westmid.openrepository.com/handle/20.500.14200/9067Background Although bone scintigraphy has been widely accepted as integral to the non-biopsy diagnostic algorithm for transthyretin amyloid cardiomyopathy (ATTR-CM), its prognostic role remains uncertain. Objectives The authors aimed to characterize changes in the referral pattern for Tc-DPD scintigraphy and its influence on the clinical phenotype and prognosis of patients diagnosed with ATTR-CM, and among those individuals in whom ATTR-CM is excluded. Methods Retrospective cohort study of all-comers referred for Tc-DPD scintigraphy to the Midlands Amyloidosis Service over 15 years. Results Of 528 patients referred for Tc-DPD scintigraphy, 477 underwent echocardiography suggestive for ATTR-CM and were included in the study. A heightened demand for Tc-DPD scintigraphy was linked to increasing proportions of referrals from cardiologists over 5-year periods (47% vs 87% vs 96%, P < 0.001). Nearly half of patients (216/477, 45%) were diagnosed with ATTR-CM: 186 had ATTRwt-CM and 30 had ATTRv-CM; the commonest TTR variant was V142I (25/30, 83%). Compared to ATTR-CM, patients with nonamyloid CM (261/477, 55%) were younger and more often female yet with similar 5-year mortality rates (40% vs 31%, P = 0.044). In an age- and sex-adjusted Cox-proportional hazards model, there was no significant difference in survival between patients with ATTRwt-CM and nonamyloid CM (HR 0.99, 95% CI: 0.98-1.38, P = 0.96). There was also no difference in mortality according to Perugini grading. Conclusions There is strikingly high mortality among patients with negative Tc-DPD scintigraphy, equivalent to that of ATTR-CM. This finding serves as a call for future studies to better characterise this seemingly overlooked cohort, with the aim of developing targeted therapies and improving outcomes.enCopyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.Journal Article