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AL Amyloidosis and Multiple Myeloma: A Complex Scenario in Which Cardiac Involvement Remains the Key Prognostic Factor.
Ríos-Tamayo, Rafael; Krsnik, Isabel; Gómez-Bueno, Manuel; Garcia-Pavia, Pablo; Segovia-Cubero, Javier; Huerta, Ana; Salas, Clara; Silvestre, Ramona Ángeles; Sánchez, Amelia; Manso, Marta; Delgado, Laura; Lahuerta, Juan José; Martínez-López, Joaquín; Duarte, Rafael F.
Afiliación
  • Ríos-Tamayo R; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Krsnik I; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Gómez-Bueno M; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Garcia-Pavia P; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Segovia-Cubero J; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Huerta A; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Salas C; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Silvestre RÁ; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Sánchez A; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Manso M; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Delgado L; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
  • Lahuerta JJ; Hospital Universitario 12 de Octubre, Instituto de Investigación del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.
  • Martínez-López J; Hospital Universitario 12 de Octubre, Instituto de Investigación del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.
  • Duarte RF; Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, 28222 Majadahonda, Spain.
Life (Basel) ; 13(7)2023 Jul 06.
Article en En | MEDLINE | ID: mdl-37511893
Monoclonal gammopathies (MGs) are a wide range of diseases that may evolve or progress over time. Comorbidity plays a critical role in this setting. The co-occurrence of two MGs is not a rare event. The evidence on the association of systemic light chain (AL) amyloidosis and multiple myeloma (MM) is scarce and controversial. Herein we aim to address this topic in a large series of patients of a referral center. All consecutive AL amyloidosis patients treated at our center from January 2005 to April 2023 were prospectively enrolled in a clinical and epidemiological registry. 141 patients diagnosed with AL amyloidosis were included, of which 7 (5%) had localized whereas 134 presented with systemic disease. The heart was the most frequently affected organ (90.3%). 25 patients (18.7%) fulfilled the IMWG diagnostic criteria of MM (AL/MM). Time-dependent association between AL and MM showed that the synchronous pattern is more frequent than the appearance of a second primary malignancy. The diagnostic delay was six months (m). Patients with AL/MM had a poorer median overall survival (OS) than AL-only patients (35.5 m, CI 95% 0-88.9, vs. 52.6 m, CI 95% 16.7-88.5), but this difference was not statistically significant. The prognosis in AL is dominated by the heart involvement, which is massive in this series. In our Cox regression model, only three prognostic variables remain as independent prognostic factors: age, N-terminal pro-brain natriuretic peptide (≥8500 ng/L), and undergoing an autologous stem cell transplant, whereas left ventricular ejection fraction shows a marginal effect. More and large studies focusing on the AL/MM association are needed to uncover the characteristics and prognostic impact of this association.
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Texto completo: 1 Bases de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Life (Basel) Año: 2023 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Bases de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Life (Basel) Año: 2023 Tipo del documento: Article País de afiliación: España