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영남의대학술지 Vol.24_No.2 Suppl. P.S676-682, Dec. 2007

Case Report

자가 조혈모세포 이식으로 치료된 전신 아밀로이드증을 동반한 다발성 골수종 1 예

A Case of Multiple Myeloma with AL Amyloidosis Successfully Treated with Autologous Stem Cell Transplantation

이하영, 이경희, 김민경, 조희순*, 현명수
영남대학교 의과대학 내과학교실, 진단검사의학과학교실*
책임저자:현명수, 대구광역시 남구 대명5동 317-1, 영남대학교 의과대학 내과학교실
Tel: (053) 620-3837, Fax: (053) 654-8386
E-mail: hms@med.yu.ac.kr

December 30, 2007

Abstract

Myeloma is a disease of neoplastic B lymphocytes that synthesize abnormal amounts of immunoglobulin (Ig) or Ig fragments. Ten to twenty percent of myeloma patients are known to develop clinical evidence of amyloid-light chain(AL) amyloidosis. A high index of suspicion, however, is needed to make a diagnosis of amyloidosis. We report a case of multiple myeloma with AL amyloidosis successfully treated with autologous stem cell transplantation. In our case, the patient presented with longstanding abdominal discomfort and anterior chest pain. Chest X-ray showed several osteolytic changes on ribs. Endoscopic biopsy revealed massive amyloid deposits in the wall of stomach and rectum. Serum/urine protein electroporesis and bone marrow biopsy confirmed the diagnosis of multiple myeloma. At 18 months after high dose chemotherapy and autologous stem cell transplantation(ASCT), the patient maintained a complete response. In patients with multiple myeloma with AL amyloidosis, high dose chemotherapy and ASCT can be effective treatment strategy.

Key Words: Amyloidosis, Multiple myeloma, Stem cell transplantation

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