KAPPA-LIGHT CHAIN DISEASE AND LAMBDA-LIGHT CHAIN DISEASE - SURVIVAL RATES AND CLINICAL MANIFESTATIONS

  • 1 January 1976
    • journal article
    • research article
    • Vol. 48  (1) , 41-51
Abstract
Patients (97) with L chain disease (LCD) were studied. The median survival from diagnosis was 30 mo. for 52 patients with .kappa.-LCD and 10 mo. for 45 patients with .lambda.-LCD (P < 0.0007). A lower proportion of .kappa.-LCD patients (15.7%) than .lambda.-LCD patients (42.2%) died within the 1st 6 mo. after diagnosis. The survival of the remaining patients with .kappa.-LCD was still longer than of those with .lambda.-LCD (P = 0.022). The shorter survival of .lambda.-LCD patients could not be ascribed to an increased incidence of recognized manifestations indicating a poor prognosis (e.g., anemia, hypercalcemia, azotemia, low albumin, the extent of osteolytic lesions or proteinuria), the incidence of amyloidosis, the clinical stage of the disease at diagnosis or the response to treatment; and remains unexplained. A comparison of the clinical manifestations of LCD with those of other myelomas revealed some differences. LCD patients were slightly younger than IgA [immunoglobulin A] and IgG patients but older than IgD patients. A 1:1 ratio of males to females was similar to the ratios in IgA and IgG myeloma, but differed from the 3:1 ratio reported for IgD myeloma. Plasma cell leukemia developed in 7/97 LCD patients, an incidence that was higher than that reported in other myelomas. The initial BUN [blood urea N] was .gtoreq. 30 mg/100 ml in 54 of 95 LCD patients, an incidence that was higher than that reported for IgA and IgG myeloma, but lower than the incidence in IgD myeloma. The incidence of amyloidosis in LCD (23 of 97 patients) was similar to that reported for IgA and IgG myeloma, but less than the incidence in IgD myeloma.

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