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首页> 外文期刊>Annals of Hematology >Asymptomatic immunoglobulin light chain amyloidosis (AL) at the time of diagnostic bone marrow biopsy in newly diagnosed patients with multiple myeloma and smoldering myeloma. A series of 144 cases and a review of the literature
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Asymptomatic immunoglobulin light chain amyloidosis (AL) at the time of diagnostic bone marrow biopsy in newly diagnosed patients with multiple myeloma and smoldering myeloma. A series of 144 cases and a review of the literature

机译：新诊断的多发性骨髓瘤和阴燃性骨髓瘤患者在进行诊断性骨髓活检时无症状免疫球蛋白轻链淀粉样变性（AL）。 144例病例报道及文献复习

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The rate of asymptomatic amyloidosis (AL) among patients with newly diagnosed multiple myeloma (MM) or smoldering multiple myeloma (SMM) is unknown. We evaluated number and clinical significance of asymptomatic AL in consecutive MM and SMM patients, not having recognition of symptomatic AL at the time of their diagnostic bone marrow biopsy. Bone marrow biopsies were stained with Congo red and considered diagnostic for AL in case of positive Congo red staining with apple-green birefringence. Biopsies from 144 patients were evaluated: 77 had a diagnosis of MM and 67 of SMM. The median age was 59 (range 26–84) years; the median follow-up was 76 months (range 0–216). Immunoglobulin isotypes were 96/144 (67%), IgG; 23/144 (16%), IgA; 12/144 (8%), light chain only; 1/77 (1%), IgD; and biclonal or indeterminate, 12/144 (8%). Fifty-eight percent (84/144) were κ restricted. The presence of amyloid was found in two cases (1%, 95% CI −0.6 to 3.2), one in MM, and one in SMM group, and none had or developed signs or symptoms suggestive of organ involvement by amyloid. Among the 142 other patients without amyloid deposition in their index bone marrow, one (0.7%, 95% CI −0.6 to 2.0) developed symptomatic AL after 119 months.
机译：新诊断的多发性骨髓瘤（MM）或阴燃的多发性骨髓瘤（SMM）患者中无症状性淀粉样变性（AL）的发生率尚不清楚。我们评估了连续MM和SMM患者无症状AL的数量和临床意义，这些患者在进行诊断性骨髓活检时并未发现有症状的AL。用刚果红对骨髓活检标本进行染色，如果刚果红对苹果绿双折射呈阳性，则可以诊断为AL。对144例患者的活检进行了评估：77例诊断为MM，67例诊断为SMM。中位年龄为59岁（26-84岁）。中位随访时间为76个月（范围0–216）。免疫球蛋白同种型为96/144（67％），IgG； 23/144（16％），IgA； 12/144（8％），仅限轻链； 1/77（1％），IgD；和双曲线或不确定的，为12/144（8％）。 58％（84/144）受κ限制。在2例病例中发现了淀粉样蛋白（1％，95％CI -0.6至3.2），MM组1例，SMM组1例，并且均未发现或发展出迹象或症状提示淀粉样蛋白累及器官。在其他142名在其指标骨髓中没有淀粉样蛋白沉积的患者中，有1名（0.7％，95％CI -0.6至2.0）在119个月后出现症状性AL。

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