Waldenström macroglobulinemia-associated renal AL amyloidosis: a case report and literature review
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By
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Jianping Zhang
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Zhifeng Li
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Huiping Chen
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Xiaoyan Bian
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Di Zhao
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Zhu Lin
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Tiekun Li
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Yanlin Zhang
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June 16, 2026
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Clinical Scorecard: Renal AL Amyloidosis Linked to Waldenström Macroglobulinemia: A Case Study and Review of Existing Literature
At a Glance
| Category | Detail |
|---|
| Condition | Waldenström macroglobulinemia with renal AL amyloidosis |
| Key Mechanisms | Lymphoplasmacytic infiltration and monoclonal IgM production |
| Target Population | Patients with Waldenström macroglobulinemia |
| Care Setting | Multidisciplinary clinical setting |
Key Highlights
- Renal AL amyloidosis is a rare complication of Waldenström macroglobulinemia.
- The patient achieved partial hematologic response after treatment with bendamustine and rituximab.
- Severe pulmonary infection was a critical adverse effect leading to the patient's death.
Guideline-Based Recommendations
Diagnosis
- Routine testing for serum and urine monoclonal free light chains in WM patients.
Management
- Bendamustine plus rituximab (BR) regimen is a reasonable first-line treatment for WM patients with renal AL amyloidosis.
Monitoring & Follow-up
- Close monitoring for adverse effects, particularly severe infections during treatment.
Risks
- Potential for severe infections as a consequence of treatment.
Patient & Prescribing Data
71-year-old female with Waldenström macroglobulinemia and renal AL amyloidosis.
Partial hematologic response noted with a decrease in serum IgM levels and slight improvement in proteinuria after three cycles of BR regimen.
Clinical Best Practices
- Monitor renal function and proteinuria in patients with WM.
- Consider the risk of infections when administering immunosuppressive therapies.
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