What percentage of myeloma patients also have amyloidosis?

00:00:08:16 - 00:00:11:18
 
What percentage of myeloma patients also have amyloidosis?

00:00:12:16 - 00:00:33:12
 
So approximately 10 to 15, maybe 20% of people with multiple myeloma have amyloidosis. A lot of it depends on how you define it, meaning that if you talk about clinically significant amyloidosis, meaning the people that have real trouble with, let's say, heart failure or the kidney trouble that I described that one can see in amyloidosis that's probably closer to 10%.

00:00:33:12 - 00:00:57:04
 
But sometimes also patients have, for example, a bone marrow biopsy with multiple myeloma. The pathologist runs the standard test for amyloidosis, which is called Congo Red. That's just a stain that they do looking for it. And they may find that in someone who really doesn't have symptoms of amyloidosis. So it's there but not causing trouble. And if you look at all people, all bone marrow biopsies for amyloidosis, it's probably closer to 15 or 20%.

00:00:57:06 - 00:01:01:05
 
So I'd say it's somewhere between ten and 20%, depending on how you define it.

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Should everyone that is diagnosed with myeloma be tested for amyloidosis?

00:01:05:23 - 00:01:22:19
 
So a great question as to whether everyone essentially undergoing a workup for something like multiple myeloma should have testing for amyloidosis. The answer is probably not necessarily, largely because the vast majority of people with multiple myeloma will not have amyloidosis.

00:01:22:20 - 00:01:49:17
 
And then in general, if you look for the symptoms and typically, you'll pick it up. But for someone who doesn't have any symptoms or anything also suggests amyloidosis, we probably shouldn't routinely look for it. So the estimate of how many myeloma patients will ultimately develop amyloid varies. Generally speaking, we think 10 to 15% of patients may develop symptomatic amyloid at some point in the course of their illness.

00:01:49:19 - 00:02:21:05
 
I personally think this is likely to become more common as myeloma patients start living longer. Estimates vary. There was there was one series from Arkansas which showed a quarter of patients that they tested had amyloid present in some tissue. There was another large series of patients with smoldering myeloma and symptomatic myeloma without symptoms of amyloid who were tested for it at Mayo, and only 1% of those patients had it.

00:02:21:05 - 00:02:29:18
 
So there's there's a wide spectrum of what's been reported in the literature. But again, I think the best number to sort of settle on is 10 to 15%.