Multiple myeloma-associated amyloidosis is an independent high-risk prognostic factor

• Published in: Annals of hematology 2009, Vol.88 (1), p.59-66
• Main Authors: Vela-Ojeda, J., García-Ruiz Esparza, M. A., Padilla-González, Y., Sánchez-Cortes, E., García-Chávez, J., Montiel-Cervantes, L., Reyes-Maldonado, E., Majluf-Cruz, A., Mayani, H.
• Format: Article
• Language: English
• Subjects: Adipose Tissue - pathology; Adult; Aged; Amyloidosis - blood; Amyloidosis - diagnosis; Amyloidosis - drug therapy; Amyloidosis - pathology; Antineoplastic Agents - therapeutic use; Biopsy; Disease-Free Survival; Female; Hematology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - diagnosis; Multiple Myeloma - drug therapy; Multiple Myeloma - pathology; Oncology; Original Article; Prognosis; Proportional Hazards Models; Regression Analysis; Remission Induction; Risk Factors
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-008-0554-0

Several prognostic factors have been recognized in patients with multiple myeloma (MM). Among the most important are: the serum levels of β2-microglobulin, albumin, and LDH; the labeling index; and an abnormal karyotype. Patients with amyloidosis (AL) have poor prognosis; however, little is known concerning the prognostic significance of AL associated to MM. In 201 consecutive patients with de novo MM, we performed a fat-pad biopsy needle aspiration (FPBNA) that was stained with Congo red. Sixty eight (34%) patients had AL and a poorer prognosis disease: lower performance status, presence of B symptoms, higher LDH and calcium values, and worse response to chemotherapy. Cox regression model for overall survival detected three variables having independent prognostic significance: the presence of AL (RR = 3.4, P