Main point
In patients with multiple myeloma, it is necessary to have high clinical suspicion to rule out the presence of AL amyloidosis.
Early recognition of AL amyloidosis will improve the prognosis of these patients.
Abstract:
Our objective is to describe the demographic, clinical, paraclinical, imaging, therapeutic, and prognostic characteristics in patients with immunoglobulin light chain (AL) amyloidosis in a high complexity institution. A retrospective cohort of patients diagnosed with AL amyloidosis was assessed at the Pablo Tobón Uribe Hospital in Medellín, Colombia, from January 2010 to May 2023. A total of 33 patients were included. Twenty (60.6%) were women, and the median age was 62 years (range, 48–77). According to the revised Mayo Clinic staging system, disease stratification was 29.6%, 44.4%, 11.1%, and 7% for stages I, II, III, and IV, respectively. Multiple myeloma and Waldenström’s macroglobulinemia were present in 22 (66%) and 1 (3%) patient, respectively. The median overall survival was 66 months (interquartile range [IQR], 30–119), decreasing to 35 months (IQR, 10–63) with cardiac involvement and 33 months (IQR, 11–55) with concurrent multiple myeloma. In contrast, patients who underwent hematopoietic transplantation had a longer survival of 136 months (IQR, 33–136). The 5-year overall survival was 44.9% (95% CI, 26.8%–63%). Our findings are consistent with the existing literature, with some distinctions such as a female predominance and high frequency of concurrent multiple myeloma. Cardiac involvement, multiple myeloma, and renal involvement were associated with reduced overall survival, suggesting their role as adverse prognostic factors.
