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The risk of renal disease is increased in lambda myeloma with bone marrow amyloid deposits
Orebro University Hospital. Department of Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Orebro University Hospital. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.ORCID iD: 0000-0001-6328-5494
Örebro University, School of Medical Sciences. 5Department of Transfusion Medicine.
Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
2017 (English)In: Journal of Blood Medicine, ISSN 1179-2736, Vol. 8Article in journal (Refereed) Published
Abstract [en]

Background: Light chain amyloidosis (AL) is a rare deposition disease and is present in 10-15% of patients with myeloma (MM). In contrast to symptomatic AL in MM, presence of bone marrow (BM) amyloid deposits (AD) in MM is not connected to kidney damage. Renal AD but not BM-AD occur mostly in MM with lambda paraprotein (lambda MM).

Methods: We investigated amyloid presence in BM clots taken at diagnosis in 84 patients with symptomatic MM and compared disease characteristics in MM with kappa paraprotein (kappa MM)/lambda MM with and without BM-AD.

Results: Lambda MM with BM-AD was compared with kappa MM without BM-AD, kappa MM with BM-AD, and lambda MM without BM-AD: lambda MM with BM-AD patients had a significantly higher mean creatinine level (4.23 mg/dL vs 1.69, 1.14, and 1.28 mg/dL, respectively) and a higher proportion presented with severe kidney failure (6/11 [55%] vs 6/32 [19%], 1/22 [5%], and 3/19 [16%], respectively). Proteinuria was more common in lambda MM with BM-AD patients compared with kappa MM without BM-AD patients (8/11 [73%] vs 5/32 [16%], respectively).

Conclusion: Kidney damage was more common in lambda MM with BM-AD indicating presence of renal AD.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd. , 2017. Vol. 8
Keyword [en]
plasma cells, neoplasms, amyloidosis, renal insufficiency, proteinuria
National Category
Hematology
Identifiers
URN: urn:nbn:se:oru:diva-56847DOI: 10.2147/JBM.S129516ISI: 000395472700001PubMedID: 28293126OAI: oai:DiVA.org:oru-56847DiVA: diva2:1085116
Available from: 2017-03-28 Created: 2017-03-28 Last updated: 2017-03-28Bibliographically approved

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