Abstract
This study aimed to evaluate the diagnostic value of bone marrow smear in systemic light chain (AL) amyloidosis and to investigate the correlation between bone marrow amyloid deposition and clinical characteristics. A total of 252 patients with AL amyloidosis were enrolled, including 126 with positive bone marrow biopsies and 126 with negative biopsies. Bone marrow smear detected amyloid deposits in 121 of 252 patients (48.0%). Among the 126 patients with positive bone marrow biopsies, 121 (96.0%) had positive smears; among the 126 patients with negative biopsies, all 126 (100%) had negative smears. The overall concordance between smear and biopsy was 98.0% (247/252). In the AL group without concomitant plasma cell or B-cell disorders, bone marrow amyloid deposition was significantly associated with λ light chain type, lower hemoglobin levels, and elevated levels of ALP, GGT, β2-MG, and NT-proBNP, suggesting a correlation with impaired liver, kidney, and cardiac function. Survival analysis indicated that bone marrow amyloid deposition had no significant impact on prognosis. Bone marrow smear may serve as a rapid screening tool for AL amyloidosis, and its combination with biopsy could enhance diagnostic efficiency.
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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Conceptualization, Yang M.; methodology, Chang Z.; software, Wang H.; validation, Tang Q. andTang M.; formal analysis, Gao X.; investigation, Yuan S.; resources, Shen D.; data curation, Zhang T.; writing—original draft preparation, Li J.; writing—review and editing, Tong H. and Jin J.; visualization, Tong J.,Xu Y. and Zhao S.; supervision, Zhu Y.; projectadministration, Chang Z. All authors have read and agreed to the published version of the manuscript.
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This study was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (Approval No.[2025] IIT Ethics Approval No.1377). As the research involved only archived samples and retrospective data collection, the requirement for informed consent was waived by the ethics committee.
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Li, J., Chang, Z., Tang, Q. et al. Diagnostic value of bone marrow smear for amyloid detection and its correlation with clinical features in systemic light-chain amyloidosis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46329-9
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DOI: https://doi.org/10.1038/s41598-026-46329-9
