EARLY DETECTION OF PLASMA CELL DYSCRASIA IN SERUM PROTEIN ELECTROPHORESIS
(Abstract release date: 05/19/16)
EHA Library. rebordao M. 06/09/16; 134849; PB1949
Dr. Manuela rebordao
Contributions
Contributions
Abstract
Abstract: PB1949
Type: Publication Only
Background
Monoclonal gammopathies are characterized by an excessive production of a single, or rarely more, types of immunoglobulins. They arise from the proliferation of one specific B cells malignant clone (plasma cell dyscrasia), which in turn generates an homogeneous population of monoclonal immunoglobulins. Early detection of these clones can be made by serum protein electrophoresis, which shows a different plot curve or a small narrow peak.
Aims
To early identify plasma cell dyscrasias by small changes in the electrophoretic curve profile, enabling a sooner diagnosis, effective follow-up and treatment.
Methods
A retrospective analysis was made. A total of 7265 electrophoretic curves from 4987 patients (no replicates) were analyzed - 3568 men and 1419 women with average ages of 51.0 and 57.8 years respectively. Patients with an electrophoretic changed pattern were divided into 2 groups. Group-I: alterations of the curve pattern between beta and gamma regions, including distortions and small peaks; Group-II: evident monoclonal peak. Electrophoresis was performed in agar gel and the chains were identified by immunofixation. Blood cells counts were studied in both groups. Statistical analysis was performed by SPSS and the critical level of significance was set at p≤0.05.
Results
Monoclonal gammopathy was identified in 3.5% of the patients (n=176). The average age of this group was 70.0 years old and they were mostly male. To characterize these monoclonal gammopathies by immunofixation, a second harvest was performed in 34 of these patients – 54.8% was associated with heavy chain IgG (n=17), 22.6% associated with IgA (n=7) and 19.4% with IgM (n=6) - kappa light chains 58% and lambda light chains 42%. 1 patient had biclonal gammopathy IgG and IgM (lambda light chain) and 3 patients did not have any band alteration.In Group-I (18 patients -58.1%) the average age was 69.6 years. The mean quantification of beta region was 15.4g/L (reference range 7-13 g / L). The mean quantification of gamma region was 13.3 g / L (reference range 6-16 g / L).The mean quantification of distortions and small peaks from this group by densitometry was 4.7g/L. This population had an average of 4.4x1012/L red blood cells and 13.6 g / L of hemoglobin. Monoclonal gammopathy of undetermined significance (MGUS) was the most common diagnosis ( 6 patients- 33.3%). This population of patients contrasts and differs significantly from Group-II (13 patients - 41.9%). Group II average age was 74 years old. Electrophoretic curve displayed a well-defined monoclonal peak of 14.7g / L (p <0.001), with an average of 3.83x1012/L red blood cells (p = 0.048) and 11.2g / L of hemoglobin (p = 0.010). Multiple myeloma (4 patients-33.3%) and Waldenström macroglobulinemia (2 patients-15.4%) were the most common diagnosis.
Conclusion
The characterization of monoclonal gammopathies by immunofixation allowed an early detection of situations that can lead to a plama cell dyscrasia. Initially, the protein levels in electrophoresis can be normal or slightly higher so, to detect these diseases in a timely effective manner is extremely important to analyse the electrophoretic curve pattern.
Session topic: E-poster
Keyword(s): MGUS, Monoclonal gammopathy, Multiple myeloma, Waldenstrom's macroglobulinemia
Type: Publication Only
Background
Monoclonal gammopathies are characterized by an excessive production of a single, or rarely more, types of immunoglobulins. They arise from the proliferation of one specific B cells malignant clone (plasma cell dyscrasia), which in turn generates an homogeneous population of monoclonal immunoglobulins. Early detection of these clones can be made by serum protein electrophoresis, which shows a different plot curve or a small narrow peak.
Aims
To early identify plasma cell dyscrasias by small changes in the electrophoretic curve profile, enabling a sooner diagnosis, effective follow-up and treatment.
Methods
A retrospective analysis was made. A total of 7265 electrophoretic curves from 4987 patients (no replicates) were analyzed - 3568 men and 1419 women with average ages of 51.0 and 57.8 years respectively. Patients with an electrophoretic changed pattern were divided into 2 groups. Group-I: alterations of the curve pattern between beta and gamma regions, including distortions and small peaks; Group-II: evident monoclonal peak. Electrophoresis was performed in agar gel and the chains were identified by immunofixation. Blood cells counts were studied in both groups. Statistical analysis was performed by SPSS and the critical level of significance was set at p≤0.05.
Results
Monoclonal gammopathy was identified in 3.5% of the patients (n=176). The average age of this group was 70.0 years old and they were mostly male. To characterize these monoclonal gammopathies by immunofixation, a second harvest was performed in 34 of these patients – 54.8% was associated with heavy chain IgG (n=17), 22.6% associated with IgA (n=7) and 19.4% with IgM (n=6) - kappa light chains 58% and lambda light chains 42%. 1 patient had biclonal gammopathy IgG and IgM (lambda light chain) and 3 patients did not have any band alteration.In Group-I (18 patients -58.1%) the average age was 69.6 years. The mean quantification of beta region was 15.4g/L (reference range 7-13 g / L). The mean quantification of gamma region was 13.3 g / L (reference range 6-16 g / L).The mean quantification of distortions and small peaks from this group by densitometry was 4.7g/L. This population had an average of 4.4x1012/L red blood cells and 13.6 g / L of hemoglobin. Monoclonal gammopathy of undetermined significance (MGUS) was the most common diagnosis ( 6 patients- 33.3%). This population of patients contrasts and differs significantly from Group-II (13 patients - 41.9%). Group II average age was 74 years old. Electrophoretic curve displayed a well-defined monoclonal peak of 14.7g / L (p <0.001), with an average of 3.83x1012/L red blood cells (p = 0.048) and 11.2g / L of hemoglobin (p = 0.010). Multiple myeloma (4 patients-33.3%) and Waldenström macroglobulinemia (2 patients-15.4%) were the most common diagnosis.
Conclusion
The characterization of monoclonal gammopathies by immunofixation allowed an early detection of situations that can lead to a plama cell dyscrasia. Initially, the protein levels in electrophoresis can be normal or slightly higher so, to detect these diseases in a timely effective manner is extremely important to analyse the electrophoretic curve pattern.
Session topic: E-poster
Keyword(s): MGUS, Monoclonal gammopathy, Multiple myeloma, Waldenstrom's macroglobulinemia
Abstract: PB1949
Type: Publication Only
Background
Monoclonal gammopathies are characterized by an excessive production of a single, or rarely more, types of immunoglobulins. They arise from the proliferation of one specific B cells malignant clone (plasma cell dyscrasia), which in turn generates an homogeneous population of monoclonal immunoglobulins. Early detection of these clones can be made by serum protein electrophoresis, which shows a different plot curve or a small narrow peak.
Aims
To early identify plasma cell dyscrasias by small changes in the electrophoretic curve profile, enabling a sooner diagnosis, effective follow-up and treatment.
Methods
A retrospective analysis was made. A total of 7265 electrophoretic curves from 4987 patients (no replicates) were analyzed - 3568 men and 1419 women with average ages of 51.0 and 57.8 years respectively. Patients with an electrophoretic changed pattern were divided into 2 groups. Group-I: alterations of the curve pattern between beta and gamma regions, including distortions and small peaks; Group-II: evident monoclonal peak. Electrophoresis was performed in agar gel and the chains were identified by immunofixation. Blood cells counts were studied in both groups. Statistical analysis was performed by SPSS and the critical level of significance was set at p≤0.05.
Results
Monoclonal gammopathy was identified in 3.5% of the patients (n=176). The average age of this group was 70.0 years old and they were mostly male. To characterize these monoclonal gammopathies by immunofixation, a second harvest was performed in 34 of these patients – 54.8% was associated with heavy chain IgG (n=17), 22.6% associated with IgA (n=7) and 19.4% with IgM (n=6) - kappa light chains 58% and lambda light chains 42%. 1 patient had biclonal gammopathy IgG and IgM (lambda light chain) and 3 patients did not have any band alteration.In Group-I (18 patients -58.1%) the average age was 69.6 years. The mean quantification of beta region was 15.4g/L (reference range 7-13 g / L). The mean quantification of gamma region was 13.3 g / L (reference range 6-16 g / L).The mean quantification of distortions and small peaks from this group by densitometry was 4.7g/L. This population had an average of 4.4x1012/L red blood cells and 13.6 g / L of hemoglobin. Monoclonal gammopathy of undetermined significance (MGUS) was the most common diagnosis ( 6 patients- 33.3%). This population of patients contrasts and differs significantly from Group-II (13 patients - 41.9%). Group II average age was 74 years old. Electrophoretic curve displayed a well-defined monoclonal peak of 14.7g / L (p <0.001), with an average of 3.83x1012/L red blood cells (p = 0.048) and 11.2g / L of hemoglobin (p = 0.010). Multiple myeloma (4 patients-33.3%) and Waldenström macroglobulinemia (2 patients-15.4%) were the most common diagnosis.
Conclusion
The characterization of monoclonal gammopathies by immunofixation allowed an early detection of situations that can lead to a plama cell dyscrasia. Initially, the protein levels in electrophoresis can be normal or slightly higher so, to detect these diseases in a timely effective manner is extremely important to analyse the electrophoretic curve pattern.
Session topic: E-poster
Keyword(s): MGUS, Monoclonal gammopathy, Multiple myeloma, Waldenstrom's macroglobulinemia
Type: Publication Only
Background
Monoclonal gammopathies are characterized by an excessive production of a single, or rarely more, types of immunoglobulins. They arise from the proliferation of one specific B cells malignant clone (plasma cell dyscrasia), which in turn generates an homogeneous population of monoclonal immunoglobulins. Early detection of these clones can be made by serum protein electrophoresis, which shows a different plot curve or a small narrow peak.
Aims
To early identify plasma cell dyscrasias by small changes in the electrophoretic curve profile, enabling a sooner diagnosis, effective follow-up and treatment.
Methods
A retrospective analysis was made. A total of 7265 electrophoretic curves from 4987 patients (no replicates) were analyzed - 3568 men and 1419 women with average ages of 51.0 and 57.8 years respectively. Patients with an electrophoretic changed pattern were divided into 2 groups. Group-I: alterations of the curve pattern between beta and gamma regions, including distortions and small peaks; Group-II: evident monoclonal peak. Electrophoresis was performed in agar gel and the chains were identified by immunofixation. Blood cells counts were studied in both groups. Statistical analysis was performed by SPSS and the critical level of significance was set at p≤0.05.
Results
Monoclonal gammopathy was identified in 3.5% of the patients (n=176). The average age of this group was 70.0 years old and they were mostly male. To characterize these monoclonal gammopathies by immunofixation, a second harvest was performed in 34 of these patients – 54.8% was associated with heavy chain IgG (n=17), 22.6% associated with IgA (n=7) and 19.4% with IgM (n=6) - kappa light chains 58% and lambda light chains 42%. 1 patient had biclonal gammopathy IgG and IgM (lambda light chain) and 3 patients did not have any band alteration.In Group-I (18 patients -58.1%) the average age was 69.6 years. The mean quantification of beta region was 15.4g/L (reference range 7-13 g / L). The mean quantification of gamma region was 13.3 g / L (reference range 6-16 g / L).The mean quantification of distortions and small peaks from this group by densitometry was 4.7g/L. This population had an average of 4.4x1012/L red blood cells and 13.6 g / L of hemoglobin. Monoclonal gammopathy of undetermined significance (MGUS) was the most common diagnosis ( 6 patients- 33.3%). This population of patients contrasts and differs significantly from Group-II (13 patients - 41.9%). Group II average age was 74 years old. Electrophoretic curve displayed a well-defined monoclonal peak of 14.7g / L (p <0.001), with an average of 3.83x1012/L red blood cells (p = 0.048) and 11.2g / L of hemoglobin (p = 0.010). Multiple myeloma (4 patients-33.3%) and Waldenström macroglobulinemia (2 patients-15.4%) were the most common diagnosis.
Conclusion
The characterization of monoclonal gammopathies by immunofixation allowed an early detection of situations that can lead to a plama cell dyscrasia. Initially, the protein levels in electrophoresis can be normal or slightly higher so, to detect these diseases in a timely effective manner is extremely important to analyse the electrophoretic curve pattern.
Session topic: E-poster
Keyword(s): MGUS, Monoclonal gammopathy, Multiple myeloma, Waldenstrom's macroglobulinemia
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