About 10 to 15 percent of people with multiple myeloma, also called myeloma, develop a condition called amyloid light-chain (AL) amyloidosis, according to 2021 research.

Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells produce proteins called antibodies that protect your body from foreign invaders like viruses and bacteria.

AL amyloidosis occurs when pieces of antibodies produced by plasma cells called light chains break off and build up in your organs. The development of AL amyloidosis is associated with a poorer outlook in people with myeloma, especially when light chains build up in the The heart..

You can learn more about the symptoms and treatment of AL amyloidosis in people with myeloma.

Multiple myeloma and amyloidosis are both related conditions.

Multiple myeloma and plasma cells

Multiple myeloma is a cancer of the bone marrow.

“Your body’s immune system is created by healthy plasma cells that make Y-shaped proteins. The germs have areas on the surface that are bound to the proteins. The binding tags the invader so that other immune cells can attack it.”

In people with multiple myeloma, cancerous plasma cells make atypical antibodies called monoclonal proteins (M-proteins). M-proteins can crowd out healthy blood cells and cause symptoms like fatigue and frequent infection.

AL amyloidosis and light chains

Heavy chains and light chains are the two main components of antibodies. When cancer cells produce light chains, they cause amyloidosis. Light chains build up in your organs and become deposits.

Amyloid can cause organ dysfunction, enlargement, and failure. It can develop in multiple organs or just one. According to a 2019 study, the most common places for it to develop are:

Organ Percent of cases
The heart. 75%
The kidneys. 65%
liver 15%
soft tissue 15%
peripheral or autonomic The nervous system is in motion. 10%
Stomach. 5%

Multiple myeloma and amyloidosis are often diagnosed together.

Multiple myeloma is a disease in which abnormal cells in the bone marrow can cause problems. These abnormal cells can cause damage to the The kidneys. and other organs.

The main problem with amyloid is that it builds up in organs.

Symptoms of multiple myeloma are typically referred to with the acronym CRAB, which stands for:

  • C: elevated calcium
  • R: renal (kidney) failure
  • A: anemia, or a low blood cell count
  • B: bone damage

The symptoms of amyloidosis are broad. There are many symptoms of multiple myeloma and AL amyloidosis.

In a 2018 study, symptoms were reported in the following frequencies by 341 people with AL amyloidosis:

AL amyloidosis Early diagnosis (<6 months) Delayed diagnosis (≥6 months)
fatigue 70.2% 86.8%
shortness of breath 52.7% 71.8%
swelling in ankles or legs 61.1% 67.9%
dizziness when standing 41.1% 57.9%
loss of appetite 38.7% 56.7%
alternating constipation and diarrhea 27.8% 32.6%
unintentional weight loss 35.1% 41.3%
enlarged tongue 13.8% 23.1%
numbness of arms and legs 20.0% 47.9%
purple color around eyes 18.3% 27.3%

According to a 2022 review, amyloidosis develops in people with multiple myeloma as the cancerous myeloma cells make large quantities of abnormal light chains.

“Some people have the light chains clump together and form structures called fibrils, which deposit in the tissues. The organ’s usual form and function are destroyed by the deposited fibrils.”

Affected organs can include:

  • The heart.
  • The person has a body part called the liver.
  • The kidneys.
  • The nervous system is in motion.
  • Stomach.

A 2021 study suggests about 10 to 15 percent of people with multiple myeloma develop AL amyloidosis and about 10 percent of people with AL amyloidosis have symptomatic multiple myeloma when they’re diagnosed.

AL amyloidosis and multiple myeloma share some genetic risk factors. The primary risk factor for AL amyloidosis is age. According to 2018 research, the median age of diagnosis is 64.

Diagnosis and treatment of AL amyloidosis is often delayed, according to a 2021 case report, because it causes nonspecific symptoms.

A 2021 review suggests the median time from the beginning of symptoms to diagnosis is 6 to 12 months, with the average person visiting 3 to 4 doctors before their diagnosis is confirmed. Diagnosis is usually most straightforward in people with kidney symptoms.

Doctors need to take a tissue sample to find evidence of amyloid in your organs for an amyloidosis diagnosis.

If AL amyloidosis is suspected, your doctor will first take a small sample with a needle from an easily accessible tissue, like the fat under your skin. This procedure is called a fat aspiration. Fat aspiration combined with a bone marrow biopsy can diagnose AL amyloidosis in about 90 percent of people.

The staining will be applied to your tissue sample to look for signs of amyloid. The stain that is most commonly used is called Congo red. Additional lab tests will be done to find out what type ofProtein is building up

A 2021 review found that the three pillars for improving the survival of AL amyloidosis include:

  • early detection
  • anti-plasma cell therapy
  • supportive care

The primary treatment for multiple myeloma with AL amyloidosis is targeting the underlying cancerous plasma cells.

This might include:

Monoclonal antibodies are being investigated for targeting amyloid deposits.

A 2021 study on 1,357 people with AL amyloidosis showed a median survival of 4 years. However, people who received their diagnoses at late stages of the disease had much shorter overall survival. According to 2020 research, how much your The heart. is affected is another of the most important factors determining your outlook.

In multiple myeloma without amyloidosis, the National Cancer Institute says outcomes have improved dramatically over the last 2 decades.

Other experts looked at long-term follow-up of one of the most common regimens for treatment of multiple myeloma in a 2021 study. Their research demonstrated a median overall survival of 126 months in all people and 78 months in people at high risk.

There are a number of different factors that affect these estimates. The stage of cancer at diagnosis and the organs affected by AL amyloidosis can change your situation. It is best to talk with your doctor about your individual outlook.

Multiple myeloma is a cancer that develops in your bone marrow. Multiple myeloma sufferers can also develop the disease. Light chains are called light amyloidosis when they build up in an organ.

If you are experiencing any strange symptoms, contact a doctor. Make sure to follow up with all your scheduled appointments so that the doctor can confirm your diagnosis. It is possible to minimize organ damage by getting a diagnosis and treatment early.