To the Editor: In the article “Resolution of Acquired Factor X Deficiency and Amyloidosis with Melphalan and Prednisone Therapy“” (April 30 issue),1 Camoriano et al. failed to address the prompt reversal of bleeding symptoms associated with melphalan and prednisone. Changes in amyloid deposits have been reported to occur over prolonged periods.2 In fact, the factor X level in the patient1 was still only 1 percent on December 3, 1985, when no symptoms of bleeding were observed. The authors neglected to discuss the prolonged thrombin time and reptilase time, which may represent a dysfibrinogenemia associated with the documented liver disease.3 Furthermore,.
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