The predictive value of bone marrow morphologic characteristics and immunostaining in primary (AL) amyloidosis

• Published in: American journal of clinical pathology Vol. 96; no. 1; pp. 95 - 99
• Main Authors: WU, S. S.-H, BRADY, K, ANDERSON, J. J, VEZINA, R, SKINNER, M, NEIMAN, R. S, WOLF, B. C
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.07.1991
• Subjects: Adult; Aged; Aged, 80 and over; Amyloidosis - metabolism; Amyloidosis - mortality; Amyloidosis - pathology; Biological and medical sciences; Bone Marrow - metabolism; Bone Marrow - pathology; Female; Humans; Immunoenzyme Techniques; Male; Medical sciences; Metabolic diseases; Middle Aged; Plasma Cells - pathology; Predictive Value of Tests; Sex Factors; Staining and Labeling; Statistics as Topic; Survival Analysis; Human; Pathology; Plasmacytosis; Cell line; Immunocytochemistry; Metabolic diseases; Exploration; Amyloidosis; Cell
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/96.1.95

The authors previously demonstrated that bone marrow plasmacytosis in primary (AL) amyloidosis may be monoclonal or polyclonal. However, the clinical implications of the degree of plasmacytosis and its clonality have not been studied. The authors evaluated 62 patients with AL amyloidosis, 40 of whom had monoclonal medullary plasma cells. There was complete concordance between the light chain class of the plasma cells in the monoclonal cases and that of the circulating paraprotein in the 22 cases associated with a paraprotein. The remaining 22 patients had polyclonal plasma cells, although a paraprotein was detected in 6. The degree of plasmacytosis was significantly higher among patients with monoclonal plasma cells and correlated inversely with length of survival. The authors' findings indicate that the quantitation of bone marrow plasma cells in AL amyloidosis by immunoperoxidase studies may predict the clinical course.