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Bone marrow findings correlate with clinical outcome in systemic AL amyloidosis patients

Hasserjian, RP; Goodman, HJB; Lachmann, HJ; Muzikansky, A; Hawkins, PN; (2007) Bone marrow findings correlate with clinical outcome in systemic AL amyloidosis patients. HISTOPATHOLOGY , 50 (5) 567 - 573. 10.1111/j.1365-2559.2007.02658.x.

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Abstract

Aims Bone marrow sampling is a key investigation in the work-up of amyloid light chain (AL) amyloidosis, but the relationship between bone marrow findings and the varied phenotype and clinical outcome of AL amyloidosis is unclear. The aim was to determine if bone marrow pathological parameters at diagnosis were related to clinical behaviour in AL amyloidosis patients.Methods and results Bone marrow findings, clinical features and outcome of 80 patients referred with a diagnosis of systemic AL amyloidosis were evaluated; six patients were subsequently excluded due to re-categorization as other forms of amyloidosis. At latest follow-up (median 66 months), 11 of the 18 patients with no identifiable bone marrow neoplastic cells (61%) versus only seven of the 56 patients with neoplastic plasma cells or non-Hodgkin's lymphoma (13%) were alive (P = 0.0046). However, neither the quantity of the neoplastic cells nor the serum light chain levels were correlated with amyloid burden or patient survival.Conclusions Identification of a neoplastic population in the bone marrow of AL amyloidosis patients by histology and immunohistochemistry correlates with poor outcome; however, the neoplastic cell burden is not prognostically significant, suggesting that additional factors are important in determining disease behaviour in AL amyloidosis.

Type: Article
Title: Bone marrow findings correlate with clinical outcome in systemic AL amyloidosis patients
DOI: 10.1111/j.1365-2559.2007.02658.x
Keywords: amyloid, bone marrow, light chain, myeloma, plasma cell, IMMUNOGLOBULIN LIGHT-CHAINS, DIAGNOSTIC EVALUATION, PLASMA-CELLS, P COMPONENT, TRANSPLANTATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: http://discovery.ucl.ac.uk/id/eprint/93032
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