PMID- 19520758
OWN - NLM
STAT- MEDLINE
DCOM- 20090824
LR  - 20240227
IS  - 1530-8561 (Electronic)
IS  - 0009-9147 (Print)
IS  - 0009-9147 (Linking)
VI  - 55
IP  - 8
DP  - 2009 Aug
TI  - Screening panels for detection of monoclonal gammopathies.
PG  - 1517-22
LID - 10.1373/clinchem.2009.126664 [doi]
AB  - BACKGROUND: The repertoire of serologic tests for identifying a monoclonal 
      gammopathy includes serum and urine protein electrophoresis (PEL), serum and 
      urine immunofixation electrophoresis (IFE), and quantitative serum free light 
      chain (FLC). Although there are several reports on the relative diagnostic 
      contribution of these assays, none has looked at the tests singly and in 
      combination for the various plasma cell proliferative disorders (PCPDs). METHODS: 
      Patients with a PCPD and all 5 assays performed within 30 days of diagnosis were 
      included (n = 1877). The diagnoses were multiple myeloma (MM) (n = 467), 
      smoldering multiple myeloma (SMM) (n = 191), monoclonal gammopathy of 
      undetermined significance (MGUS) (n = 524), plasmacytoma (n = 29), extramedullary 
      plasmacytoma (n = 10), Waldenstrom macroglobulinemia (WM) (n = 26), primary 
      amyloidosis (AL) (n = 581), light chain deposition disease (LCDD) (n = 18), and 
      POEMS syndrome (n = 31). RESULTS: Of the 1877 patients, 26 were negative in all 
      assays. Omitting urine from the panel lost an additional 23 patients (15 MGUS, 6 
      AL, 1 plasmacytoma, 1 LCDD), whereas the omission of FLC lost 30 patients (6 MM, 
      23 AL, and 1 LCDD). The omission of serum IFE as well as urine lost an additional 
      58 patients (44 MGUS, 7 POEMS, 5 AL, 1 SMM, and 1 plasmacytoma). CONCLUSIONS: The 
      major impact of using a simplified screening panel of serum PEL plus FLC rather 
      than PEL, IFE, and FLC is an 8% reduction in sensitivity for MGUS, 23% for POEMS 
      (7 patients), 4% for plasmacytoma (1 patient), 1% for AL, and 0.5% for SMM. There 
      is no diminution in sensitivity for detecting MM, macroglobulinemia, and LCDD.
FAU - Katzmann, Jerry A
AU  - Katzmann JA
AD  - Division of Clinical Biochemistry & Immunology, Department of Laboratory Medicine 
      & Pathology, Mayo Clinic, Rochester, MN, 55905, USA. katzmann.jerry@mayo.edu
FAU - Kyle, Robert A
AU  - Kyle RA
FAU - Benson, Joanne
AU  - Benson J
FAU - Larson, Dirk R
AU  - Larson DR
FAU - Snyder, Melissa R
AU  - Snyder MR
FAU - Lust, John A
AU  - Lust JA
FAU - Rajkumar, S Vincent
AU  - Rajkumar SV
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
LA  - eng
GR  - P01 CA062242/CA/NCI NIH HHS/United States
GR  - R01 CA107476/CA/NCI NIH HHS/United States
GR  - CA 62242/CA/NCI NIH HHS/United States
GR  - CA 107476/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20090611
PL  - England
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
RN  - 0 (Blood Proteins)
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
CIN - Clin Chem. 2010 Apr;56(4):677-9; author reply 679-80. PMID: 20110450
MH  - *Blood Proteins/analysis
MH  - Cohort Studies
MH  - Electrophoresis/methods
MH  - Female
MH  - Humans
MH  - *Immunoglobulin Light Chains/blood
MH  - Immunoproliferative Disorders/*diagnosis
MH  - Male
MH  - Medical Records
MH  - Paraproteinemias/*diagnosis
MH  - Proteinuria/*urine
MH  - Sensitivity and Specificity
MH  - Serologic Tests/*methods
PMC - PMC3773468
MID - NIHMS498187
COIS- Authors' Disclosures of Potential Conflicts of Interest: Upon manuscript 
      submission, all authors completed the Disclosures of Potential Conflict of 
      Interest form. Potential conflicts of interest: Employment or Leadership: None 
      declared. Consultant or Advisory Role: None declared. Stock Ownership: None 
      declared. Honoraria: None declared. Research Funding: Research grants CA 107476 
      and CA 62242 from the National Cancer Institute. Expert Testimony: None declared.
EDAT- 2009/06/13 09:00
MHDA- 2009/08/25 09:00
PMCR- 2013/09/15
CRDT- 2009/06/13 09:00
PHST- 2009/06/13 09:00 [entrez]
PHST- 2009/06/13 09:00 [pubmed]
PHST- 2009/08/25 09:00 [medline]
PHST- 2013/09/15 00:00 [pmc-release]
AID - clinchem.2009.126664 [pii]
AID - 10.1373/clinchem.2009.126664 [doi]
PST - ppublish
SO  - Clin Chem. 2009 Aug;55(8):1517-22. doi: 10.1373/clinchem.2009.126664. Epub 2009 
      Jun 11.