BETA - How common is it for patients with multiple myeloma to get amyloidosis or vice versa?

How common is it for patients with multiple myeloma to get amyloidosis or vice versa? How common is it for patients with multiple myeloma to get amyloidosis or vice versa and what to look for for patients with multiple myeloma to worry about whether or not they're going to have amyloidosis. So, amyloidosis and multiple myeloma I would say are part of the same spectrum of plasma cell disorders. Personally I feel amyloidosis is more challenging and whichever way you look at it, a little bit more tough to manage because you cannot end up doing a lot of different things. If the diagnosis is properly done and the workup is thorough, most patients with light chain amyloidosis do not progress to multiple myeloma. However, I've seen not a big percentage but a fairly significant few patients who progress from multiple myeloma to AL amyloidosis. The biggest kind of predictor, I would say the biggest clinical sign of symptomatology comes from cardiac side effects which is why it's very important to know what medicines you're on and what protocol you're on because we shouldn't just attribute any side effects from a cardiac perspective just to the medication the protocol. Cardiac complications can happen but it's also very important to kind of keep a mind the possibility of AL amyloidosis and there's very clear-cut criteria and very clear-cut diagnostic testing to be done for that. At our institution our preferred modalities and MRI followed by a cardiac biopsy if necessary and that usually helps make the diagnosis very definitively of AL amyloidosis with patients with multiple myeloma. Usually an amyloidosis primarily kind of is treated a little bit differently, the protocol is a little bit different and there are some clinical trials right now that are looking at specific antibodies to maybe help alleviate the burden of cardiac toxicity in those patients. For multiple myeloma the mainstay of therapy is mostly killing the plasma cell and that does give the hard time to recover but we're hoping that if these studies with the antifibrils do become positive that could be something we could extrapolate to patients with myeloma and organ damage as well. I have seen patients have kidney damage from it, I've seen patients have liver damage from it so amyloid can mimic anything. It's very hard to be like well this is not from amyloid so I believe that as someone who does amyloid and sees a lot of amyloid patients just having a high level of suspicion for it and not be cavalier just to assign every side effect or complication just to the drug and actually kind of going through with a thorough workup is very necessary.