Emilin Zacharias, Poornima A Manjrekar, Sowndarya K, Sindhu
Emilin Zacharias, Poornima A Manjrekar, Sowndarya K, Sindhu*
Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Volume - 16,
Issue - 8,
Year - 2023
Multiple myeloma is a malignant plasma cell disorder identified with M spikeon serum protein electrophoresis (SPE) during routine laboratory work up. This study aimed to analyze the utility of laboratory tests suchas SPE, immunofixation electrophoresis (IFE), CBC, RFT, LFT, calcium, phosphorus, beta 2 microglobulins, LDH, serum-free light chain assay (SFLC), Bence Jones Proteinuria (BJP), BM biopsy, BM smear and radiological evidence for lytic lesionsin cases of paraproteinemia. Data for the above parameters from 2017 January to 2021 March were obtained from the data management system of the central lab. Biochemical parameters were correlated with M spike value using Karl Pearson’s correlation coefficient (P-value <0.05 will be significant).7.7% SPE reports had M spike with a mean age of 64 years in males and 63 years in females (male/female ratio, 1: 0.76). M spike showed a significant positive association with total protein, globulin, uric acid and negative association with albumin. IgG kappa type (51%) predominant in IFE reports. The common presentation from hematological data was normocytic normochromic anemia with occasional rouleaux formation. Osteolytic lesion was present in 86% of reported cases. Associated biochemical, hematological, and radiological correlates of the positive cases could be documented in only less than 20% of the positive cases. Ours is a tertiary care hospital and the associated lab is also a reference lab where samples from in and around the city are tested. After the preliminary SPE, it could be possible that the patients were further evaluated and continued treatment at some other facility.
Cite this article:
Emilin Zacharias, Poornima A Manjrekar, Sowndarya K, Sindhu. Analytical correlation of Laboratory tests with clinical findings in cases of Paraproteinemia. Research Journal of Pharmacy and Technology 2023; 16(8):3583-7. doi: 10.52711/0974-360X.2023.00591
Emilin Zacharias, Poornima A Manjrekar, Sowndarya K, Sindhu. Analytical correlation of Laboratory tests with clinical findings in cases of Paraproteinemia. Research Journal of Pharmacy and Technology 2023; 16(8):3583-7. doi: 10.52711/0974-360X.2023.00591 Available on: https://rjptonline.org/AbstractView.aspx?PID=2023-16-8-11
1. Mayur S. Mayur R., Sunil R. Melphalanflufenamide is an Anticancer medication used to treat multiple Myeloma: A Review. Asian Journal of Research in Pharmaceutical Sciences. 2021; 11(4):291-4.https://doi.org/10.52711/2231-5659.2021.00045
2. Victor A. Oleg I. Stanislav G. Marsel A. et al.. Low-Intensive Electropulse Therapy for Correction of Clinical and Functional Manifestations of Neuropathy in Multiple Myeloma. Research J. Pharm. and Tech 2018; 11(9): 4161-4165https:// doi.org/10.5958/0974-360X.2018.00764.3
3. Caers J, Garderet L, Kortüm KM, O’Dwyer ME, van de Donk NW, Binder M, et al European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when. haematologica. 2018; 103(11):1772-84.https:// doi.org/ 10.3324/haematol.2018.189159
4. Rebecca. G, Anitha M, Dhanraj. Multiple Myeloma – A Review. Research J. Pharm. and Tech 2017; 10(10):3628-3634.https://doi.org/10.5958/0974-360X.20362817.00658.8
5. Mikhael JR, Dingli D, Roy V, Reeder CB, Buadi FK, et al Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines 2013. InMayo Clinic Proceedings 2013;88(4):360-376.https://doi.org/10.1016/j.mayocp.2013.
6. Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor Iet al Global burden of multiple myeloma: a systematic analysis for the global burden of disease study 2016. JAMA oncology. 2018;4(9):1221-7.https://doi.org/10.1001/jamaoncol.2018.2128
7. Bora K. Distribution of multiple myeloma in India: Heterogeneity in incidence across age, sex and geography. Cancer epidemiology. 2019; 59:215-20.https://doi.org/10.1016/j.canep.2019.02.010
8. Sri Anusha M, Raja S. Lenalidomide loaded lactoferrin nanoparticle for controlled delivery and enhanced therapeutic efficacy. Research J. Pharm. and Tech 2018; 11(9): 4010-4014.https://doi.org/10.5958/0974-360X.2018.00737.0
9. Kanitsap N, Umpunthongsiri S. The Possibility of Developing Screening Criteria for Patients Suspected Multiple Myeloma (MM) at Thammasat University Hospital. Journal of the Medical Association of Thailand= Chotmaihetthangphaet. 2016 ;99: S189-94.
10. Riccomi G, Fornaciari G, Giuffra V. Multiple myeloma in paleopathology: A critical review. International Journal of Paleopathology. 2019; 24:201-12https://doi.org/10.1016/j.ijpp.2018.12.001
11. Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, et al. Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. Journal of clinical oncology. 2015;33(26):2863.https://doi.org /10.1200/jco.2015.61.2267
12. Pawar NHegde A. Usefulness of serum globulin levels for discriminating patients with monoclonal gammopathies/ paraproteinemias. Biomedicine. 2021;41(1):31-5. https://doi.org/10.51248/.v41i1.529
13. Poudel B, Mittal A, Shrestha R, Farooqui MS, Yadav NK, et al. Liver involvement in multiple myeloma: a hospital based retrospective study. Asian Pacific Journal of Cancer Prevention. 2012;13(5):2153-5.https://doi.org /10.7314/apjcp.2012.13.5.2153
14. Bhandari MS, Mazumder A, Vesole DH. Liver involvement in multiple myeloma. Clinical Lymphoma and Myeloma. 2007 ;7(8):538-40. https://doi.org / 10.3816/clm.2007. n.039
15. Quiñones‐Torrelo C, Villanueva P, Rodríguez‐Muñoz A, Abellán L, et al A. When an analytical interference is a useful diagnostic tool: finding monoclonal gammopathies in routine analysis. Journal of Clinical Laboratory Analysis. 2016;30(2):140-4. https://doi.org 10.1002/jcla.21827
16. Kumar SK, Rajkumar V, Kyle RA, van Duin M, Sonneveld P, Mateos MV, et al Multiple myeloma. Nat Rev Dis Primers. 2017; 3:1–20. https://doi.org / 10.1038/nrdp.2017.46.
17. Roy V. Artifactual laboratory abnormalities in patients with paraproteinemia. Southern medical journal. 2009; 102(2):167-70.https://doi.org/10.1097/SMJ.0b013e3181831f6a
18. Larsen J, Kumar SK, Dispenzieri A, Kyle RA, Katzmann JA, et al. Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma. Leukemia. 2013;27(4):941-6.https://doi.org / 10.1038/leu.2012.296
19. Talbot B, Wright D, Basnayake K. The importance of screening for serum free light chains in suspected cases of multiple myeloma and their impact on the kidney.Case Reports Published online. 2014 Oct 17;10–3https://doi.org /10.1136/bcr-2014- 206688.
20. Raj S, Guha B, Rodriguez C, Krishnaswamy G. Paraproteinemia and serum protein electrophoresis interpretation. Annals of Allergy, Asthma & Immunology. 2019;122(1):11-6.https://doi.org /10.1016/j.anai.2018.08.004.
21. Magnano L, de Larrea CF, Elena M, Cibeira MT, Tovar N, et al. Prognostic impact of serum heavy/light chain pairs in patients with monoclonal gammopathy of undetermined significance and smoldering myeloma: long-term results from a single institution. Clinical Lymphoma Myeloma and Leukemia. 2016;16(6):e71-7.https://doi.org /10.3390/diagnostics11112020