Zhao ZY, Tang N, Fu XJ, Lin LE. Secondary light chain amyloidosis with Waldenström’s macroglobulinemia and intermodal marginal zone lymphoma: A case report. World J Clin Cases 2022; 10(29): 10779-10786 [PMID: 36312489 DOI: 10.12998/wjcc.v10.i29.10779]
Corresponding Author of This Article
Li-Er Lin, Doctor, Chief Physician, Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. linlier268@163.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2022; 10(29): 10779-10786 Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10779
Secondary light chain amyloidosis with Waldenström’s macroglobulinemia and intermodal marginal zone lymphoma: A case report
Zhen-Yu Zhao, Nan Tang, Xiang-Jun Fu, Li-Er Lin
Zhen-Yu Zhao, Xiang-Jun Fu, Li-Er Lin, Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Nan Tang, Department of Emergency Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Author contributions: Zhao ZY and Tang N gathered information and wrote the manuscript; Fu XJ performed the evaluation, diagnosis, and treatment; all authors approved the final contents of the manuscript.
Supported byMedical and Health Research Project of Hainan Province, No. 21A200197.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Er Lin, Doctor, Chief Physician, Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. linlier268@163.com
Received: July 12, 2022 Peer-review started: July 12, 2022 First decision: August 4, 2022 Revised: August 17, 2022 Accepted: September 4, 2022 Article in press: September 4, 2022 Published online: October 16, 2022 Processing time: 78 Days and 19.4 Hours
Abstract
BACKGROUND
The co-existence of Waldenström’s macroglobulinemia (WM) with internodal marginal zone lymphoma (INMZL) is rare and often associated with poor prognosis.
CASE SUMMARY
We present a Chinese female patient who developed secondary light chain amyloidosis due to WM and INMZL and provides opinions on its systemic treatment. A 65-year-old woman was diagnosed with WM 6 years ago and received Bruton tyrosine kinase inhibitor monotherapy for two years. Her INMZL was confirmed due to left cervical lymphadenopathy. The patient presented with oedema in both lower limbs one year ago, and was diagnosed with secondary light chain amyloidosis. Treatment with the BC regimen (rituximab 375 mg/m2 monthly for 6-8 courses, and bendamustine 90 mg/m2 per day × 2, monthly for six courses) was initiated, but not tolerated due to toxic side effects. Bortezomib-based therapy was given for two months, including bortezomib, dexamethasone, and zanubrutinb. Oedema in both lower limbs was relieved and treatment efficacy was evaluated as partial remission.
CONCLUSION
A detailed clinical evaluation and active identification of the aetiology are recommended to avoid missed diagnosis and misdiagnosis.
Core Tip: Waldenström's macroglobulinemia (WM) is a lymphoplasmacytic lymphoma, and internodal marginal zone lymphoma (INMZL) is another rare subtype of clinically inertial non-Hodgkin's lymphoma. We report a rare secondary light chain amyloidosis case due to WM and INMZL. We also retrieved related articles indexed in PubMed. Bortezomib-based therapy, including bortezomib, dexamethasone, and zanubrutinb, was administered for two months, and treatment efficacy was evaluated as partial remission. Treatment should be based on the patient's physiological age, life expectancy, and tolerance to treatment. Therefore, we recommend detailed clinical evaluation and active identification of the etiology to avoid missed diagnosis and misdiagnosis.
