The prognostic value of diagnosing concurrent multiple myeloma in immunoglobulin light chain amyloidosis

Shira Dinner*, Wesley Witteles, Ronald Witteles, Anthony Lam, Sally Arai, Richard Lafayette, Tracy I. George, Stanley L. Schrier, Michaela Liedtke

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

The prevalence and prognostic value of a concomitant diagnosis of symptomatic or asymptomatic multiple myeloma (MM), as defined by the current International Myeloma Working Group (IMWG) criteria, in patients with immunoglobulin light chain amyloidosis (AL), are unknown. We studied 46 consecutive patients with AL who underwent quantification of serum M-protein and clonal bone marrow plasma cells, as well as a comprehensive evaluation for end organ damage by MM. Using standard morphology and CD138 immunohistochemical staining, 57% and 80% of patients were found to have concomitant MM, respectively. Nine patients exhibited end organ damage consistent with a diagnosis of symptomatic MM. While overall survival was similar between AL patients with or without concurrent myeloma (1-year overall survival 68% vs. 87%; P = 0·27), a diagnosis of symptomatic myeloma was associated with inferior outcome (1-year overall survival 39% vs. 81%; P = 0·005). Quantification of bone marrow plasma cells by both standard morphology and CD138 immunohistochemistry identified a much higher prevalence of concurrent MM in patients with AL than previously reported. Evaluation of bone marrow plasma cell infiltration and presence of myeloma associated end organ damage could be clinically useful for prognostication of patients with AL.

Original languageEnglish (US)
Pages (from-to)367-372
Number of pages6
JournalBritish Journal of Haematology
Volume161
Issue number3
DOIs
StatePublished - May 2013

Keywords

  • Amyloidosis
  • Immunohistochemistry
  • Morphology
  • Multiple myeloma

ASJC Scopus subject areas

  • Hematology

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