Waldenström's macroglobulinemia associated with serum amyloid A protein amyloidosis: pitfalls in diagnosis and successful treatment with melphalan-based autologous stem cell transplant

Acta Haematol. 2013;130(3):146-9. doi: 10.1159/000347036. Epub 2013 May 9.

Abstract

Waldenström's macroglobulinemia (WM) is increasingly being associated with amyloidosis particularly of the amyloid light-chain variety. We report on one of the few cases of WM associated with serum amyloid A protein (AA) amyloidosis. Autologous stem cell transplant (ASCT) is now being increasingly used for the treatment of amyloidosis, but most studies are small case series. Traditionally AA amyloid is associated with connective tissue disorders and periodic fever syndromes and has been treated by addressing the underlying condition. We present the first case of serum amyloid A being treated with melphalan-based ASCT to deal with the underlying WM and thereby control the amyloid, thus demonstrating the viability of this novel approach for the treatment of this disorder.

MeSH terms

  • Aged
  • Amyloidosis / blood
  • Amyloidosis / complications
  • Amyloidosis / therapy
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Melphalan / administration & dosage
  • Myeloablative Agonists / administration & dosage
  • Serum Amyloid A Protein / metabolism*
  • Transplantation, Autologous
  • Waldenstrom Macroglobulinemia* / blood
  • Waldenstrom Macroglobulinemia* / complications
  • Waldenstrom Macroglobulinemia* / therapy

Substances

  • Myeloablative Agonists
  • Serum Amyloid A Protein
  • Melphalan