AL Amyloidosis and Multiple Myeloma: A Complex Scenario in Which Cardiac Involvement Remains the Key Prognostic
Rafael Ríos-Tamayo1, Isabel Krsnik1, Manuel Gómez-Bueno1
1Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
Life (Basel, Switzerland)
|July 29, 2023
Summary
Systemic light chain amyloidosis (AL) and multiple myeloma (MM) co-occurrence was studied in 141 patients. The AL/MM association appeared synchronous and impacted survival, though not significantly, highlighting the need for further research.
Area of Science:
- Hematology
- Oncology
- Cardiology
Background:
- Monoclonal gammopathies (MGs) can evolve, with comorbidities like co-occurring MGs being significant.
- The association between systemic light chain (AL) amyloidosis and multiple myeloma (MM) lacks extensive evidence.
Purpose of the Study:
- To investigate the characteristics and prognostic impact of co-occurring AL amyloidosis and multiple myeloma (AL/MM).
Main Methods:
- Prospective enrollment of 141 AL amyloidosis patients from January 2005 to April 2023.
- Assessment of diagnostic criteria for multiple myeloma (MM) in AL amyloidosis patients.
- Survival analysis comparing AL/MM patients with AL-only patients.
Main Results:
- 18.7% of AL amyloidosis patients met criteria for MM (AL/MM).
- Synchronous AL/MM was more frequent than sequential occurrence.
- AL/MM patients showed a trend towards poorer overall survival, but the difference was not statistically significant.
- Age, NT-proBNP levels, and autologous stem cell transplant were independent prognostic factors in AL amyloidosis.
Conclusions:
- The AL/MM association is observed in a significant subset of AL amyloidosis patients.
- While not statistically significant in this series, the AL/MM association warrants further investigation due to potential survival implications.
- Cardiac involvement remains a dominant prognostic factor in AL amyloidosis, irrespective of MM co-occurrence.
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