medigraphic.com
ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2015, Number 1

<< Back Next >>

Rev Mex Patol Clin Med Lab 2015; 62 (1)

Usefulness of laboratory tests in the diagnosis of multiple myeloma

Pedroza VA, Zamora PA

Language: Spanish
References: 23
Page: 55-62
PDF size: 352.47 Kb.


ABSTRACT

In the case of a disease like multiple myeloma, its symptoms, complications, and mortality, a quick and timely detection is a priority. Considering the importance of a comprehensive assessment, this project aims at evaluating commonly requested tests, like serum protein electrophoresis, serum light chains, Bence Jones protein and serum protein immunofixation, and according to the results, verifying their sensitivity and specificity in order to detect the relevance, necessity and usefulness of each of them in the comprehensive diagnosis of multiple myeloma. A retrospective study of samples taken and sent to the Central Laboratory of Medical Diagnostics Olab for testing protein electrophoresis, Bence Jones protein, serum protein immunofixation and determination of serum light chains was performed. Comparing the results of the reliability indices described, it was determined that if there is a test that is most useful in the diagnosis of multiple myeloma, this test could be the determination of light chains in serum because of its specificity, which means that in this test, altered values would appear as soon as alterations in the production of plasma cells start in the bone marrow; however, the test could not confirm the existence of multiple myeloma because of its low sensitivity. Therefore, an accurate diagnosis could be obtained using, in addition, serum protein electrophoresis, since such test has the parameters studied in balance.


REFERENCES

  1. Secretaría de Salud. Dirección General de Información en Salud; 2002.

  2. Secretaría de Salud. Dirección General de Epidemiología. Compendio de cáncer; 2000. Mortalidad/morbilidad. Registro histopa- tológico de neoplasias malignas; 2000.

  3. Palomo GI, Pereira GJ, Palma BJ. Hematología, fisiopatologías y diagnóstico; Editorial Universidad de Talca 2005.

  4. Collins CD. Multiple myeloma. Ireland: St Vincents University Hospital; 2010.

  5. American Cancer Society. Mieloma múltiple. American Cancer Society; 2013. p. 1, 13, 14.

  6. The Myeloma Trialist’s Collaborative Group. Combination che-motherapy versus melphalan plus prednisone as treatment for mul- tiple myeloma: an overview of 6.633 patients from 27 randomized trials. JCO. 1998; 16: 3832-3842.

  7. Di Lorenzo S. Análisis de orina y de los líquidos corporales. 5a edición. Madrid: Editorial Médica Panamericana; 2008. p. 58.

  8. Kyle RA, Gertz MA, Witzig TE et al. Revisión de 1,027 pacientes con mieloma múltiple recién diagnosticado. Mayo Clinic Proc. 2003; 78: 21-33.

  9. Durie BG, Salmon SE. A clinical staging system for multiple mye- loma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975; 36: 842-854.

  10. Hungria VTM, Maiolino A. Mieloma Múltiplo: Progressose desafios. Rev Bras Hematol Hemoter. 2007; 29: 1-2.

  11. Barbosa-de Carvalho NM, Morais-Sarmento-Campos ML. Identi- ficación de cadenas ligeras libres en suero y su aplicación en las gammapatías monoclonales. Rev Hematol. 2010; 11 (4): 199-207.

  12. International Myeloma Foundation. Entendiendo la electroforésis de proteínas. North Hollywood, California: International Myeloma Foundation; 2011. p. 6, 11, 12, 15.

  13. Daval S, Tridon A, Mazeron N, Ristori J, Evrard B. Risk of antigen excess in serum free light chain measurements. Clin Chem. 2007; 53 (11): 1985-1986.

  14. Bird JM, Owen RG, D’Sa S, Snowden JA, Pratt G, Ash-Croft J et al. Guidelines for the diagnosis and management of multiple myeloma 2011. Br J Haematol. 2011; 154: 32-75

  15. Rajkumar SV. Multiple myeloma. Rochester, MN, USA: Division of Hematology, Mayo Clinic; 2009.

  16. Landgren O, Kyle RA, Pfeiffer RM et al. Gammapatía monoclonal de significado incierto (GMSI), precede constantemente mieloma múltiple: un estudio prospectivo. Sangre. 2009; 113: 5412-5417.

  17. Rajkumar SV, Gahrton G, Bergsagel PL. Enfoque para el tratamiento del mieloma múltiple: un choque de filosofías. Sangre. 2011; 118: 3205-3211.

  18. Munshi NC. Investigative tools for diagnosis and management. Hematology and soc Hematol Educ Program 2008; 298-305

  19. Inmunofijación en suero. Código SCPC (Sociedad Colombiana de Patología Clínica). Medicina & Laboratorio. 2013; 19: 395-398.

  20. Tate JR, Mollee P, Dimeski G, Carter AC, Gill D. Analytical perfor- mance of serum free light-chain assay during monitoring of patients with monoclonal light-chain diseases. Clin Chim Acta. 2007; 376 (1-2): 30-36.

  21. Rajkumar SV. Multiple myeloma. Update on diagnosis, risk-strati- fication, and management, 2012 January. Rochester, Minnesota: Division of Hematology, Mayo Clinic; 2012.

  22. Graff SL. Análisis de orina (Atlas color). Buenos Aires: Editorial Médica Panamericana; 1993. pp. 30-40.

  23. Pascali E. Bence Jones proteins identified by immunofixation electrophoresis of concentrated urine. Clin Chem 1994; 40: 945-946.




2020     |     www.medigraphic.com