INCIDENCE AND IMPACT OF LIGHT-CHAIN ASSOCIATED (AL) AMYLOIDOSIS ON THE PROGNOSIS OF PATIENTS WITH MULTIPLE-MYELOMA TREATED WITH AUTOLOGOUS TRANSPLANTATION

Little is known about the incidence of clinically occult AL amyloid in patients with multiple myeloma and its impact on prognosis of these p atients. To address these issues, subcutaneous fat pad aspirates (SAFA ) and bone marrow biopsies were evaluated for the presence of amyloid in a cohort of newly diagnosed patients with multiple myeloma prior to enrollment on a phase II study including tandem transplants. Organ di rected biopsies were performed when clinically indicated. Presence of amyloid at greater than or equal to 1 site was noted in 32 patients (3 8%.). SAFA was positive in 25 (31%), bone marrow in 8 patients (10%) a nd other organ sites in 7 patients. Patients with and without amyloid did not differ in disease characteristics, in particular no lambda pre dominance was observed in patients with amyloid. Event free survival ( 59+ vs 52 months; p = .9) and overall survival (59+ vs 66+ months; p = .9) were similar in both groups. Even the seven patients with symptom atic organ involvement with AL amyloid had a median overall survival o f 38+ months. In conclusion, AL amyloidosis occurs more often than pre viously reported, but its presence does not influence the outcome of t hese patients after transplantation.