Amyloidosis associated with chronic lymphocytic leukemia

Abstract

Chronic lymphocytic leukemia (CLL), the most common form of leukemia in Western countries, rarely induces glomerular disease, but membranoproliferative glomerulonephritis or immunotactoid glomerulopathy has been reported. The proliferating cells in CLL are of mature B-cell origin and produce monoclonal immunoglobulin (Ig), thus leading to various kinds of autoimmune disorders or immunotactoid glomerulopathy. Although there have been a few reported cases of amyloidosis accompanying CLL, the type of amyloid fibrils has not been demonstrated nor described in detail, particularly regarding monoclonal Ig productivity. We report a rare case of amyloidosis associated with CLL, in which we detected ?-light chain type monoclonal Ig in the sera, urine, and on the surface membrane of lymphocytes, and discuss an association between monoclonal Ig-related disease and non-Hodgkin's lymphoma.

Concurrent nephrotic syndrome and acute renal failure caused by chronic lymphocytic leukemia (CLL): a case report and literature review

“…It is well known that most amyloid depositions associated with plasma disorders are lambda-light chains [16]. On the contrary, in AL amyloid caused by CLL, the monoclonal light chains detected are predominantly kappa type as in our case [3,5]. Though AL amyloidosis caused by plasma cell dyscrasia often has a poor prognosis with a median survival of 35.2 months from diagnosis due to the poor response to chemotherapy [17], CLL-associated AL amyloidosis were reported to be significantly alleviated and obtained a prolonged survival of more than 7 years [2].…”

Idelalisib plus rituximab is effective in systemic AL amyloidosis secondary to chronic lymphocytic leukaemia

“…AL amyloidosis is associated with an underlying clonal plasma cell dyscrasia or with light‐chain producing B‐cell lymphoproliferative disorders, particularly lymphoplasmocytic lymphomas. Amyloidosis in chronic lymphocytic leukaemia (CLL) has rarely been described …”

“…Amyloidosis in chroniclymphocytic leukaemia (CLL) has rarely been described. [1][2][3] We report on a patient with CLL who developed systemic AL amyloidosis that was treated with the phosphoinositide 3-kinase (PI3K) inhibitor, idelalisib, plus rituximab.A 61-year-old man was followed at our Haematology Unit since June 2004 for CLL. At diagnosis, he had lymphocytosis (22.000/μL), thrombocytopenia (platelets 4.000/μL), and an IgM/K monoclonal component (M-protein) of 2 g/L.…”

“…lymphocytic leukaemia (CLL) has rarely been described. [1][2][3] We report on a patient with CLL who developed systemic AL amyloidosis that was treated with the phosphoinositide 3-kinase (PI3K) inhibitor, idelalisib, plus rituximab.…”

Chemotherapy for renal AL amyloidosis: treatment results and outcomes in 49 patients from a single center

“…In this particular type of amyloidosis monoclonal immunoglobulin light chains, produced by plasma cell clone, undergo aggregation and form amyloid deposits, almost always systemically, and kidneys are one of the most frequent sites of amyloid deposition [3,4,5]. AL amyloidosis may occur in some patients with overt multiple myeloma, and rarely arise in association with Waldenström macroglobulinemia and nonHodjkin lymphoma/leukaemia, but usually the degree of plasma cell proliferation in AL amyloidosis is low or even undetectable, thus for many years it used to be named "primary" amyloidosis, the term which is actually eliminated [6,7,8,9,10,11,12,13].…”