Abstract 847P
Background
Elevated amylase in Multiple myeloma (MM) was first described in 1988. It has been postulated that translocation of chromosome 1, where the amylase gene is situated is responsible for the ectopic production from the malignant plasma cells. Previous case reports have shown that patients with hyperamylasemia in MM are associated with extensive bone disease, rapid progression and shorter survival. The study was conducted to ascertain the degree of elevated amylase in MM patients.
Methods
It was conducted as a single institutional study. In newly diagnosed or relapsed cases of MM, serum amylase levels were determined. The study included patients with normal lipase and creatine clearance and without any evidence of intestinal obstruction or perforation. Patients with amylase value > 100 U/L were designated to have “elevated amylase level” in the study. Statistical analysis done using SPSS version 20.
Results
Out of 58 patients with MM, 29.3 % were found to have elevated serum amylase levels and the mean value was 130±69 U/L. The median age of patients was 65 years. The male to female ratio was 1.9: 1. There was no statistically significant association between age, gender, type of heavy chain class, light chain or high-risk cytogenetics. Among the patients with ISS stage I, II and III, 20.8 %, 31.3 %, and 41.2 % were noted to have elevated amylase levels. A statistically significant association was noted between the presence of extramedullary disease (EMD) and elevated amylase level (p-value 0.028). Higher mortality at 29.4 % and shorter mean survival of 30.2±3.3 months was noted in those patients with elevated amylase level in comparison to 17 % mortality and mean survival of 51.7±4.9 months in those with normal amylase level. Table: 847P
| Normal amylase % (n) | Elevated amylase % (n) | |
| Age<65>65 | 70.3 (26)71.5 (15) | 29.7 (11)28.5 (6) |
| GenderMaleFemales | 71.1 (27)70.0 (14) | 28.6 (11)30.0 (6) |
| Heavy chainIgGIg AIg MN/A | 68.2 (15)68.8 (11)100.0 (1)73.7 (14) | 31.8 (7)31.3 (5)0.0 (0)26.3 (5) |
| Light chainKappaLambdaN/A | 71.4 (25)72.2 (13)60.0 (3) | 28.6 (10)27.8 (5)40.0 (2) |
| ISS StageIIIIIIRelapse | 79.2 (19)68.8 (11)58.8 (10)100.0 (1) | 20.8 (5)31.3 (5)41.2 (7)0.0 (0) |
| High risk cytogeneticPresentAbsentN/A | 83.3 (5)68.0 (17)70.3 (19) | 16.7 (1)32.0 (8)29.6 (8) |
| Extramedullary diseasePresentAbsent | 41.7 (5)78.3 (36) | 58.3 (7)21.7 (10) |
Conclusions
Patients with MM associated with elevated amylase levels were more likely to be diagnosed with advanced ISS stage, higher mortality and shorter survival. A significant association was noted between elevated amylase level and EMD. The limitations of the study were small sample size.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.