IDENTIFICATION OF MULTIPLE MYELOMA IN PATIENTS ATTENDING EMERGENCY SERVICES WITH SEVERE BONE PAIN
(Abstract release date: 05/19/16)
EHA Library. Rios Tamayo R. 06/09/16; 134898; PB1998
Dr. Rafael Rios Tamayo
Contributions
Contributions
Abstract
Abstract: PB1998
Type: Publication Only
Background
Bone metastases are due to a variety of primary tumors that include Multiple Myeloma (MM) and solid tumors (lung, breast, prostate). Its effects result in pain refractory to conventional analgesic treatments and osteolysis leading to pathological bone lesions. Sometimes, patients with age>50 years, intense and repetitive bone pain are treated with analgesics without assessing the possibility of a MM at Emergency Services (ES). Typically, after several visits to the ES because of progressive increase of pain and evidence of bone damage the patient is admitted to study a possible MM. Early study of the pathological bone lesions is crucial for a correct diagnosis and to increase the survival time of patients. The protocol “SPE+FLC” that uses serum free light chains determination (FLC) and serum protein electrophoresis (SPE) enables sensitive quantification of a possible monoclonal component in the study of MM.
Aims
The aim of our work is to study the diagnostic utility of the protocol 'SPE+FLC'.
Methods
During a period of 12 months, we studied 44 patients with age>50 years old, intense bone pain and recurrent visits to Emergency Service where imaging methods (X-Rays, CT scan and MRI) showed osteolytic lesions, vertebrae collapse and pathological fractures that may be associated a MM or metastasis from a primary tumor of unknown origin (TU). The protocol (SPE+FLC) was applied to every patient to study a possible MM and the determination of tumor markers to discard a TU with bone metastasis.
Results
The diagnosis was: MM in 16 patients (36%), TU with bone metastasis in 14 patients (32%) and 14 patients without tumoral pathology (32%). In MM patients, the median age was 68 years (range 58-75) and the median time from symptoms to diagnosis was 5 months (range 2-7) with a median number of visits to Emergency Service of 3. The diagnosis was intact immunoglobulin MM in 13 patients and Bence-Jones MM in 3 patients. According to ISS system for MM; there were 2 patients in stage 1 (12%), 4 patients in stage 2 (25%) and 10 patients in stage 3 (63%). During the study there were 3 MM related deaths. The protocol “SPE+FLC” had a sensitivity of 100%, specificity of 97%, PPV of 94% and PNV of 100%.
Conclusion
In patients with age>50 years, intense bone pain with pathological bone lesions, the application of the protocol “SPE+FLC” allow us to detect a possible MM in order to apply an early treatment and increase the survival time of the patient.
Session topic: E-poster
Keyword(s): Diagnosis, Free light chain, Myeloma
Type: Publication Only
Background
Bone metastases are due to a variety of primary tumors that include Multiple Myeloma (MM) and solid tumors (lung, breast, prostate). Its effects result in pain refractory to conventional analgesic treatments and osteolysis leading to pathological bone lesions. Sometimes, patients with age>50 years, intense and repetitive bone pain are treated with analgesics without assessing the possibility of a MM at Emergency Services (ES). Typically, after several visits to the ES because of progressive increase of pain and evidence of bone damage the patient is admitted to study a possible MM. Early study of the pathological bone lesions is crucial for a correct diagnosis and to increase the survival time of patients. The protocol “SPE+FLC” that uses serum free light chains determination (FLC) and serum protein electrophoresis (SPE) enables sensitive quantification of a possible monoclonal component in the study of MM.
Aims
The aim of our work is to study the diagnostic utility of the protocol 'SPE+FLC'.
Methods
During a period of 12 months, we studied 44 patients with age>50 years old, intense bone pain and recurrent visits to Emergency Service where imaging methods (X-Rays, CT scan and MRI) showed osteolytic lesions, vertebrae collapse and pathological fractures that may be associated a MM or metastasis from a primary tumor of unknown origin (TU). The protocol (SPE+FLC) was applied to every patient to study a possible MM and the determination of tumor markers to discard a TU with bone metastasis.
Results
The diagnosis was: MM in 16 patients (36%), TU with bone metastasis in 14 patients (32%) and 14 patients without tumoral pathology (32%). In MM patients, the median age was 68 years (range 58-75) and the median time from symptoms to diagnosis was 5 months (range 2-7) with a median number of visits to Emergency Service of 3. The diagnosis was intact immunoglobulin MM in 13 patients and Bence-Jones MM in 3 patients. According to ISS system for MM; there were 2 patients in stage 1 (12%), 4 patients in stage 2 (25%) and 10 patients in stage 3 (63%). During the study there were 3 MM related deaths. The protocol “SPE+FLC” had a sensitivity of 100%, specificity of 97%, PPV of 94% and PNV of 100%.
Conclusion
In patients with age>50 years, intense bone pain with pathological bone lesions, the application of the protocol “SPE+FLC” allow us to detect a possible MM in order to apply an early treatment and increase the survival time of the patient.
Session topic: E-poster
Keyword(s): Diagnosis, Free light chain, Myeloma
Abstract: PB1998
Type: Publication Only
Background
Bone metastases are due to a variety of primary tumors that include Multiple Myeloma (MM) and solid tumors (lung, breast, prostate). Its effects result in pain refractory to conventional analgesic treatments and osteolysis leading to pathological bone lesions. Sometimes, patients with age>50 years, intense and repetitive bone pain are treated with analgesics without assessing the possibility of a MM at Emergency Services (ES). Typically, after several visits to the ES because of progressive increase of pain and evidence of bone damage the patient is admitted to study a possible MM. Early study of the pathological bone lesions is crucial for a correct diagnosis and to increase the survival time of patients. The protocol “SPE+FLC” that uses serum free light chains determination (FLC) and serum protein electrophoresis (SPE) enables sensitive quantification of a possible monoclonal component in the study of MM.
Aims
The aim of our work is to study the diagnostic utility of the protocol 'SPE+FLC'.
Methods
During a period of 12 months, we studied 44 patients with age>50 years old, intense bone pain and recurrent visits to Emergency Service where imaging methods (X-Rays, CT scan and MRI) showed osteolytic lesions, vertebrae collapse and pathological fractures that may be associated a MM or metastasis from a primary tumor of unknown origin (TU). The protocol (SPE+FLC) was applied to every patient to study a possible MM and the determination of tumor markers to discard a TU with bone metastasis.
Results
The diagnosis was: MM in 16 patients (36%), TU with bone metastasis in 14 patients (32%) and 14 patients without tumoral pathology (32%). In MM patients, the median age was 68 years (range 58-75) and the median time from symptoms to diagnosis was 5 months (range 2-7) with a median number of visits to Emergency Service of 3. The diagnosis was intact immunoglobulin MM in 13 patients and Bence-Jones MM in 3 patients. According to ISS system for MM; there were 2 patients in stage 1 (12%), 4 patients in stage 2 (25%) and 10 patients in stage 3 (63%). During the study there were 3 MM related deaths. The protocol “SPE+FLC” had a sensitivity of 100%, specificity of 97%, PPV of 94% and PNV of 100%.
Conclusion
In patients with age>50 years, intense bone pain with pathological bone lesions, the application of the protocol “SPE+FLC” allow us to detect a possible MM in order to apply an early treatment and increase the survival time of the patient.
Session topic: E-poster
Keyword(s): Diagnosis, Free light chain, Myeloma
Type: Publication Only
Background
Bone metastases are due to a variety of primary tumors that include Multiple Myeloma (MM) and solid tumors (lung, breast, prostate). Its effects result in pain refractory to conventional analgesic treatments and osteolysis leading to pathological bone lesions. Sometimes, patients with age>50 years, intense and repetitive bone pain are treated with analgesics without assessing the possibility of a MM at Emergency Services (ES). Typically, after several visits to the ES because of progressive increase of pain and evidence of bone damage the patient is admitted to study a possible MM. Early study of the pathological bone lesions is crucial for a correct diagnosis and to increase the survival time of patients. The protocol “SPE+FLC” that uses serum free light chains determination (FLC) and serum protein electrophoresis (SPE) enables sensitive quantification of a possible monoclonal component in the study of MM.
Aims
The aim of our work is to study the diagnostic utility of the protocol 'SPE+FLC'.
Methods
During a period of 12 months, we studied 44 patients with age>50 years old, intense bone pain and recurrent visits to Emergency Service where imaging methods (X-Rays, CT scan and MRI) showed osteolytic lesions, vertebrae collapse and pathological fractures that may be associated a MM or metastasis from a primary tumor of unknown origin (TU). The protocol (SPE+FLC) was applied to every patient to study a possible MM and the determination of tumor markers to discard a TU with bone metastasis.
Results
The diagnosis was: MM in 16 patients (36%), TU with bone metastasis in 14 patients (32%) and 14 patients without tumoral pathology (32%). In MM patients, the median age was 68 years (range 58-75) and the median time from symptoms to diagnosis was 5 months (range 2-7) with a median number of visits to Emergency Service of 3. The diagnosis was intact immunoglobulin MM in 13 patients and Bence-Jones MM in 3 patients. According to ISS system for MM; there were 2 patients in stage 1 (12%), 4 patients in stage 2 (25%) and 10 patients in stage 3 (63%). During the study there were 3 MM related deaths. The protocol “SPE+FLC” had a sensitivity of 100%, specificity of 97%, PPV of 94% and PNV of 100%.
Conclusion
In patients with age>50 years, intense bone pain with pathological bone lesions, the application of the protocol “SPE+FLC” allow us to detect a possible MM in order to apply an early treatment and increase the survival time of the patient.
Session topic: E-poster
Keyword(s): Diagnosis, Free light chain, Myeloma
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