title: Systemic amyloidosis associated with chronic lymphocytic leukemia/small lymphocytic lymphoma.
abstract: To clarify the presentation and course of patients with chronic lymphocytic leukemia (CLL) and amyloidosis. Mayo databases were interrogated for patients who carried a diagnosis of amyloidosis and CLL evaluated at Mayo Clinic, Rochester from January 1974 to October 2012. Charts were abstracted and data analyzed. Of the 33 patients identified, 20 (61%) were diagnosed with AL and 13 (39%) with non-AL. Only four patients had immunoglobulin light chain amyloidosis (AL) that could be solely attributed to the CLL clone; another six had both a plasma cell clone and a CLL clone that shared the same light chain. Median overall survival was 15.6 months for patients with AL and 58.1 months for patients with non-AL. For patients with AL management involved chemotherapy targeted toward monoclonal plasma cells, lymphocytes or both, and for patients with non-AL no specific amyloid treatment was administered. AL is a rare complication of CLL, but in this elderly population of patients non-AL is nearly as common. Distinguishing between these two groups is essential since patients with non-AL amyloidosis have better outcomes and they do not require cytotoxic chemotherapy to treat their amyloidosis.
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Taxiarchis V
authors.initials: TV
authors.lastname: Kourelis
authors.forename: Morie
authors.initials: M
authors.lastname: Gertz
authors.forename: Clive
authors.initials: C
authors.lastname: Zent
authors.forename: Martha
authors.initials: M
authors.lastname: Lacy
authors.forename: Robert
authors.initials: R
authors.lastname: Kyle
authors.forename: Prashant
authors.initials: P
authors.lastname: Kapoor
authors.forename: Steven
authors.initials: S
authors.lastname: Zeldenrust
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.forename: Thomas
authors.initials: T
authors.lastname: Witzig
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hayman
authors.forename: John
authors.initials: J
authors.lastname: Lust
authors.forename: Stephen
authors.initials: S
authors.lastname: Russell
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.forename: Vincent S
authors.initials: VS
authors.lastname: Rajkumar
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000209:etiology* / Q000517:prevention & control; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D002999:Clone Cells / Q000378:metabolism; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000517:prevention & control; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009215:Myometrium / Q000378:metabolism / Q000473:pathology; D010950:Plasma Cells / Q000378:metabolism; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D007147:Immunoglobulin Light Chains