Monoclonal gammopathies (MGs), including systemic light-chain (AL) amyloidosis and multiple myeloma (MM), often overlap clinically. AL amyloidosis results from amyloid fibril deposition caused by abnormal plasma cell light chains, damaging organs like the heart and kidneys. MM involves clonal plasma cell proliferation with related organ damage or malignancy markers. Among 141 patients with AL who were studied, 18.7% had concurrent MM, mostly synchronous. Heart involvement was observed in 90.3% of patients with AL, with median overall survival (OS) at 45.9 months. ASCT improved OS, while NT-proBNP ≥ 8500 pg/mL predicted poorer outcomes.

The synchronous occurrence of AL and MM is underrecognized, necessitating early diagnosis and management to improve survival. Clinicians should use cardiac biomarkers, renal function, and bone marrow analysis to identify AL in patients with MG, particularly those newly diagnosed with MM. Multidisciplinary approaches and standardized diagnostics are vital to reducing delays. The study underscores the need for large-scale research and clinical trials to better understand AL-MM associations and optimize treatment strategies.

Reference: Ríos-Tamayo R, Krsnik I, Gómez-Bueno M,. AL Amyloidosis and Multiple Myeloma: A Complex Scenario in Which Cardiac Involvement Remains the Key Prognostic Factor. Life (Basel). 2023;13(7):1518. doi: 10.3390/life13071518.