In a comprehensive study at a referral center, 141 patients with systemic light chain (AL) amyloidosis were analyzed, revealing that 25 (18.7%) also met the diagnostic criteria for multiple myeloma (MM). This co-occurrence frequently manifests simultaneously rather than as sequential primary malignancies. Despite the common origin of clonal malignant plasma cells, AL and MM diverge significantly in clinical presentation.

The study underscores the varied impact of AL and MM on patient outcomes, with those having both conditions showing poorer survival rates, though not statistically significant due to sample size limitations. Heart involvement, predominantly observed in AL cases, significantly influences prognosis. Independent prognostic factors identified include age, levels of N-terminal pro-brain natriuretic peptide, and undergoing autologous stem cell transplant, highlighting the need for targeted therapeutic strategies. This research emphasizes the necessity for ongoing study to refine diagnostic criteria and treatment protocols, particularly in recognizing and managing the complexities when both conditions present simultaneously.

Reference: Ríos-Tamayo R, Krsnik I, Gómez-Bueno M, et al. AL Amyloidosis and Multiple Myeloma: A Complex Scenario in Which Cardiac Involvement Remains the Key Prognostic Factor. Life (Basel). 2023 Jul 6;13(7):1518. doi: 10.3390/life13071518. PMID: 37511893; PMCID: PMC10382070.