Haematologica
HOME HELP FEEDBACK TABLE OF CONTENTS ARCHIVE SUBSCRIPTIONS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Perfetti, V
Right arrow Articles by Merlini, G
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Perfetti, V
Right arrow Articles by Merlini, G
Haematologica, Vol 80, Issue 5, 409-415
Copyright © 1995 by Ferrata Storti Foundation

Journal Article

Diagnostic approach to and follow-up of difficult cases of AL amyloidosis

V Perfetti, P Garini, MC Vignarelli, MG Marinone, I Zorzoli, and G Merlini

Research Laboratory of Biotechnology, University of Pavia, Italy.

BACKGROUND. Routine electrophoretic analysis fails to detect a monoclonal component (MC) in a considerable portion of AL amyloidosis patients. We investigated whether the combination of immunofixation (IF) on agarose gel electrophoresis and bone marrow plasma cell (BMPC) light chain kappa/lambda ratio analysis could contribute to diagnosis in these cases. The possible use of the BMPC kappa/lambda ratio in monitoring the clone was also investigated. METHODS. We performed BMPC kappa/lambda ratio analysis and IF of serum and urine in 16 selected patients with no detectable MC at routine analysis, despite clinical features suggestive of primary amyloidosis. An anti-idiotypic monoclonal antibody specific for the amyloidogenic immunoglobulin and the BMPC kappa/lambda ratio were used to monitor the clone in a patient who underwent autologous peripheral blood stem cell transplantation. RESULTS. Abnormal kappa/lambda ratios were found in 14 (sensitivity 87.5%), and a MC in 12 (sensitivity 75%). Combination of the two analyses confirmed diagnosis in all cases. In one patient changes in the size of the clone, monitored on serial bone marrow aspirates by an anti-idiotypic antibody, paralleled variations of the kappa/lambda ratio. CONCLUSIONS. This study demonstrates that the combined use of IF and the BMPC kappa/lambda ratio is extremely powerful in AL amyloidosis. In addition, the BMPC kappa/lambda ratio should be considered for monitoring the amyloidogenic clone when serum or urine MC is not quantifiable.


This article has been cited by other articles:


Home page
 HeartHome page
L Bernardi, C Passino, C Porta, E Anesi, G Palladini, and G Merlini
Widespread cardiovascular autonomic dysfunction in primary amyloidosis: does spontaneous hyperventilation have a compensatory role against postural hypotension?
Heart, December 1, 2002; 88(6): 615 - 621.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Pathol.Home page
V. Perfetti, A. M. L. Coluccia, D. Intini, U. Malgeri, M. C. Vignarelli, S. Casarini, G. Merlini, and A. Neri
Translocation t(4;14)(p16.3;q32) Is a Recurrent Genetic Lesion in Primary Amyloidosis
Am. J. Pathol., May 1, 2001; 158(5): 1599 - 1603.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
V. Perfetti, P. Ubbiali, M. C. Vignarelli, M. Diegoli, R. Fasani, M. Stoppini, A. Lisa, P. Mangione, L. Obici, E. Arbustini, et al.
Evidence That Amyloidogenic Light Chains Undergo Antigen-Driven Selection
Blood, April 15, 1998; 91(8): 2948 - 2954.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK TABLE OF CONTENTS ARCHIVE SUBSCRIPTIONS
Copyright © 1995 by the Ferrata Storti Foundation.