Recurrent, isolated factor X deficiency in myeloma: repeated normalization of factor X levels after cytostatic chemotherapy followed by late treatment failure associated with the development of systemic amyloidosis.

Abstract

We describe the case of a 64-year-old woman with isolated severe factor X deficiency associated with kappa light chain myeloma. At the time of diagnosis there was no evidence for amyloidosis. Complete remission (CR) of myeloma as well as normalization of factor X levels were achieved after cytostatic chemotherapy. Subsequently, factor X deficiency recurred twice without any evidence for relapse of myeloma. The first time factor X normalized again following cytostatic treatment, the second time, however, factor X deficiency was refractory to chemotherapy. Finally, relapse of myeloma became evident associated with rapidly progressing, systemic amyloidosis, which was fatal within a few months. Initially, factor X infusion studies showed a normal recovery, but when amyloidosis became overt the recovery decreased to 0%. We assume that factor X deficiency was due to a binding of factor X to kappa light chains associated with the proliferation of the malignant myeloma cell clone.

• Authors: I Schwarzinger, M Stain-Kos, P Bettelheim, I Pabinger, P Kyrle, P Kalhs, S Kapiotis, U Jäger, K Lechner
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 68 Issue 6 Pg. 648-51 (Dec 07 1992) ISSN: 0340-6245 [Print] Germany
• PMID: 1287879 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Factor X

Topics

• Amyloidosis (etiology)
• Antineoplastic Agents (therapeutic use)
• Blood Coagulation Tests
• Factor X (administration & dosage, metabolism, pharmacokinetics)
• Factor X Deficiency (complications, drug therapy)
• Female
• Half-Life
• Humans
• Infusions, Intravenous
• Middle Aged
• Multiple Myeloma (blood, complications, drug therapy)
• Neoplasm Recurrence, Local (complications)
• Recurrence
• Remission Induction (methods)
• Time Factors