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Classification of amyloidosis by the detection of clonal excess of plasma cells in the bone marrow.
J Lab Clin Med. 1991 Jul; 118(1):33-9.JL

Abstract

In 28 cases of amyloidosis, bone marrow was examined to determine whether detection of clonal excess of plasma cells could be used to distinguish immunoglobulin-derived amyloidosis from other forms of amyloidosis. Patients were selected from a group of 315 cases of biopsy-proved amyloidosis in which bone marrow aspiration and biopsy had been done. There was no detectable monoclonal immunoglobulin in the serum or in the urine in 28 patients. Of 13 patients with immunoglobulin-derived amyloidosis, a clonal excess of plasma cells in the bone marrow could be detected in 11 (sensitivity, 85%), even though no immunoglobulin could be found circulating in the serum or urine after immunofixation with two light chain antisera of different sources. The 15 remaining patients had other forms of amyloidosis; 14 had polyclonal populations of plasma cells in the bone marrow (specificity, 93%). The positive predictive value of clonal excess was 92% and its negative predictive value was 88%. We conclude that, in the subset of patients with amyloidosis who do not have a circulating M component in the serum or urine detection of a clonal excess of plasma cells is useful in characterizing the type of amyloidosis. Correct classification is important for appropriate assessment of prognosis and therapy for the group of patients.

Authors+Show Affiliations

Dysproteinemia Clinic, Mayo Clinic, Rochester, MN 55905.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1906082

Citation

Gertz, M A., et al. "Classification of Amyloidosis By the Detection of Clonal Excess of Plasma Cells in the Bone Marrow." The Journal of Laboratory and Clinical Medicine, vol. 118, no. 1, 1991, pp. 33-9.
Gertz MA, Greipp PR, Kyle RA. Classification of amyloidosis by the detection of clonal excess of plasma cells in the bone marrow. J Lab Clin Med. 1991;118(1):33-9.
Gertz, M. A., Greipp, P. R., & Kyle, R. A. (1991). Classification of amyloidosis by the detection of clonal excess of plasma cells in the bone marrow. The Journal of Laboratory and Clinical Medicine, 118(1), 33-9.
Gertz MA, Greipp PR, Kyle RA. Classification of Amyloidosis By the Detection of Clonal Excess of Plasma Cells in the Bone Marrow. J Lab Clin Med. 1991;118(1):33-9. PubMed PMID: 1906082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Classification of amyloidosis by the detection of clonal excess of plasma cells in the bone marrow. AU - Gertz,M A, AU - Greipp,P R, AU - Kyle,R A, PY - 1991/7/1/pubmed PY - 1991/7/1/medline PY - 1991/7/1/entrez SP - 33 EP - 9 JF - The Journal of laboratory and clinical medicine JO - J. Lab. Clin. Med. VL - 118 IS - 1 N2 - In 28 cases of amyloidosis, bone marrow was examined to determine whether detection of clonal excess of plasma cells could be used to distinguish immunoglobulin-derived amyloidosis from other forms of amyloidosis. Patients were selected from a group of 315 cases of biopsy-proved amyloidosis in which bone marrow aspiration and biopsy had been done. There was no detectable monoclonal immunoglobulin in the serum or in the urine in 28 patients. Of 13 patients with immunoglobulin-derived amyloidosis, a clonal excess of plasma cells in the bone marrow could be detected in 11 (sensitivity, 85%), even though no immunoglobulin could be found circulating in the serum or urine after immunofixation with two light chain antisera of different sources. The 15 remaining patients had other forms of amyloidosis; 14 had polyclonal populations of plasma cells in the bone marrow (specificity, 93%). The positive predictive value of clonal excess was 92% and its negative predictive value was 88%. We conclude that, in the subset of patients with amyloidosis who do not have a circulating M component in the serum or urine detection of a clonal excess of plasma cells is useful in characterizing the type of amyloidosis. Correct classification is important for appropriate assessment of prognosis and therapy for the group of patients. SN - 0022-2143 UR - https://www.unboundmedicine.com/medline/citation/1906082/Classification_of_amyloidosis_by_the_detection_of_clonal_excess_of_plasma_cells_in_the_bone_marrow_ L2 - http://www.diseaseinfosearch.org/result/380 DB - PRIME DP - Unbound Medicine ER -