Systemic amyloidosis associated with chronic lymphocytic leukemia/small lymphocytic lymphoma

Abstract

To clarify the presentation and course of patients with chronic lymphocytic leukemia (CLL) and amyloidosis. Mayo databases were interrogated for patients who carried a diagnosis of amyloidosis and CLL evaluated at Mayo Clinic, Rochester from January 1974 to October 2012. Charts were abstracted and data analyzed. Of the 33 patients identified, 20 (61%) were diagnosed with AL and 13 (39%) with non-AL. Only four patients had immunoglobulin light chain amyloidosis (AL) that could be solely attributed to the CLL clone; another six had both a plasma cell clone and a CLL clone that shared the same light chain. Median overall survival was 15.6 months for patients with AL and 58.1 months for patients with non-AL. For patients with AL management involved chemotherapy targeted toward monoclonal plasma cells, lymphocytes or both, and for patients with non-AL no specific amyloid treatment was administered. AL is a rare complication of CLL, but in this elderly population of patients non-AL is nearly as common. Distinguishing between these two groups is essential since patients with non-AL amyloidosis have better outcomes and they do not require cytotoxic chemotherapy to treat their amyloidosis.