Variation In The Characteristics Of Multiple Myeloma With Amyloidosis

Objective:Patients with multiple myeloma complicated by amyloidosis can form amyloid deposition in the bone marrow. In this study, a bone marrow smear method was establish to detect amyloidosis. Based on the results obtained from the method, Further systematic analysis of biomarker type and expression level of patients with multiple myeloma complicated by amyloidosis and non-amyloidosis. To help the diagnosis of multiple myeloma complicated by amyloidosis.Methods:Patients with multiple myeloma were included at Tianjin Medical University Cancer Institute and Hospital. According to clinical symptoms, peripheral blood cells examination, bone marrow Wright’s staining, cytochemistry, and chromosome screening, nucleated cells staining and cell morphology were performed in patients with MM. Bone marrow cells were then stained with Congo red, H&E, Wright’s, hematoxylin to observe the amyloid deposition.Secondly, Congo red staining and polarized examination were performed in44patients with MM patients. The MM patients were classified as amyloid-positive and amyloid-negative groups. The SYSMEX XE-5100hematology analyzer were used to measure the number of RBC, WBC, Hb and PLT. Siemens BN Ⅱwere used to detect IgA, IgG, IgM, κ and λ in serum. HITACHI7600automatic biochemical analyzer were used to detect serum LDH, LDH1, ALT, AST, mAST, ALP, GGT, CHE, ADA, AFU, GPDA,5-NT, TP, Alb, Palb and Glo. Wright’s stained was used to determine bone marrow cells.Results:(1) Bone marrow cells which were stained with Wright’s could not determine amyloid deposition.(2) After bone marrow cells staining with Congo red, combined with Wright’s staining, the cellular and structural turns to be fuzzy.(3) After Congo red staining, hematoxylin alcohol dehydration, bone marrow cells stained well. Immunoassay was used to determine the serum immunoglobulin levels. In MM patients with bone marrow amyloidosis, IgG content were significantly lower than the negative group,κ and λ levels tended to decrease with no statistically differences. Analysis of serum biochemical markers showed serum LDH and LD-1activity was significantly higher than that in the amyloid-negative group in bone marrow amyloidosis patients. The WBC and monocyte count were significantly higher than that in the amyloid-negative group (p<0.05). However, there was no statistically significant difference in TP, Alb, ALT, AST, blood RBC, HGB and PLT.Conclusions:1. To explore the bone marrow examination amyloidosis methods to determine the bone marrow smears stained with Congo red, the use of hematoxylin, after bleaching of alcohol have a good nucleus and cytoplasm of nuclear staining results. Bone marrow can be identified using this method in the diagnosis of amyloidosis, multiple myeloma, while laying the technical foundation for further found concurrent diagnosis of multiple myeloma bone marrow amyloidosis laboratory markers.2. In patients with multiple myeloma complicated by and amyloidosis-negative IgA, IgG, IgM, κ and λ levels, only IgG immune globulin decreased significantly.3. In patients with multiple myeloma complicated by amyloidosis, WBC count, total monocyte counts were significantly increased,4. By analysis of serum LDH, LD-1, ALT, AST, mAST, ALP, GGT, CHE, ADA, AFU, GPDA,5-NT, TP, Alb, Palb and Glo and other16biochemical markers, w LHD and LDH-1appeared in a statistically significant increase in MM complicated by bone marrow amyloidosis patients.5. IgG, WBC count, count the number of monocytes, LDH and LDH-1may be used as biomarkers of MM complicated by amyloidosis.