Rheumatology

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Multiple myeloma-associated amyloidosis is an independent high-risk prognostic factor
Annals of Hematology, 07/31/08

Vela-Ojeda J et al. - Multiple myeloma (MM)-associated amyloidosis (AL) represents a poorer prognosis disease even in the absence of symptoms at diagnosis, and this specific association may be considered as an independent high-risk prognostic factor.

• Aim was to evaluate prognostic significance of AL associated to MM
• In 201 pts with de novo MM, a fat-pad biopsy needle aspiration (FPBNA) was stained with Congo red

• 34% pts had AL and a poorer prognosis disease: lower performance status, presence of B symptoms, higher LDH and calcium values, and worse response to chemotherapy
• 3 variables having independent prognostic significance: the presence of AL, serum albumin levels <3.5 g/dl and pts not achieving CR or very good PR
• In 28% of pts with de novo MM, FPBNA was useful to detect incidental amyloidosis
• During f/u, 69% of these pts had symptoms of AL
• Excluding 16 pts with symptoms of AL at diagnosis, OS was worse in pts who developed later symptoms of AL

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