AL amyloidosis associated with IgM monoclonal protein: A distinct clinical entity

Giovanni Palladini, Paola Russo, Tiziana Bosoni, Gabriele Sarais, Francesca Lavatelli, Andrea Foli, Letizia Zenone Bragotti, Vittorio Perfetti, Laura Obici, Franco Bergesio, Riccardo Albertini, Remigio Moratti, Giampaolo Merlini

Research output: Contribution to journalArticlepeer-review

Abstract

IgM-associated AL amyloidosis is rare and may represent a distinct entity. Sixty (7%) of 868 consecutive AL patients referred to our center had an IgM monoclonal protein. They were significantly older than non-IgM patients (median, 67 years vs. 62 years), had a higher frequency of lymph-node involvement (25% vs. 2%) and significantly lower median proteinuria (1.2 g/24h vs. 3.4 g/24h), N-terminal pro-natriuretic peptide type-B (1177 ng/L vs. 2135 ng/L) and troponin I (0.02 ng/mL vs. 0.05 ng/mL). In IgM patients, κ light-chains were more frequent (42% vs. 23%) and the involved free light-chain concentration was lower (median 63 mg/L vs. 182 mg/L). Serum albumin and NT-proBNP were independent prognostic determinants. Response to treatment improved survival. The 14 patients who received melphalan/dexamethasone showed a 64% hematologic (complete remissions, 29%) and a 43% organ response rate. IgM-associated AL amyloidosis is a distinct entity, with less advanced organ dysfunction. Treatment with melphalan/ dexamethasone might be effective in these patients.

Original languageEnglish
Pages (from-to)80-83
Number of pages4
JournalClinical Lymphoma and Myeloma
Volume9
Issue number1
DOIs
Publication statusPublished - 2009

Keywords

  • Dexamethasone
  • Melphalan
  • Prednisone
  • Prognosis
  • Response
  • Waldenström
  • Waldenström's macroglobulinemia

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Hematology

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