scholarly journals Mass spectrometry for the evaluation of monoclonal proteins in multiple myeloma and related disorders: an International Myeloma Working Group Mass Spectrometry Committee Report

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
David L. Murray ◽  
Noemi Puig ◽  
Sigurdur Kristinsson ◽  
Saad Z. Usmani ◽  
Angela Dispenzieri ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Multiple Myeloma ◽  
Working Group ◽  
Current Data ◽  
Immunoglobulin M ◽  
M Protein ◽  
Routine Practice ◽  
Committee Report ◽  
Monoclonal Immunoglobulin ◽  
International Myeloma Working Group

AbstractPlasma cell disorders (PCDs) are identified in the clinical lab by detecting the monoclonal immunoglobulin (M-protein) which they produce. Traditionally, serum protein electrophoresis methods have been utilized to detect and isotype M-proteins. Increasing demands to detect low-level disease and new therapeutic monoclonal immunoglobulin treatments have stretched the electrophoretic methods to their analytical limits. Newer techniques based on mass spectrometry (MS) are emerging which have improved clinical and analytical performance. MS is gaining traction into clinical laboratories, and has replaced immunofixation electrophoresis (IFE) in routine practice at one institution. The International Myeloma Working Group (IMWG) Mass Spectrometry Committee reviewed the literature in order to summarize current data and to make recommendations regarding the role of mass spectrometric methods in diagnosing and monitoring patients with myeloma and related disorders. Current literature demonstrates that immune-enrichment of immunoglobulins coupled to intact light chain MALDI-TOF MS has clinical characteristics equivalent in performance to IFE with added benefits of detecting additional risk factors for PCDs, differentiating M-protein from therapeutic antibodies, and is a suitable replacement for IFE for diagnosing and monitoring multiple myeloma and related PCDs. In this paper we discuss the IMWG recommendations for the use of MS in PCDs.

Feline Lymphoplasmacytic Stomatitis Associated with Monoclonal Gammopathy and Bence-Jones Proteinuria

1994 ◽  
Vol 11 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Kenneth F. Lyon
Keyword(s):  
Multiple Myeloma ◽  
Oral Cavity ◽  
Serum Protein ◽  
Monoclonal Gammopathy ◽  
Alkylating Agent ◽  
Protein Electrophoresis ◽  
M Protein ◽  
Monoclonal Immunoglobulin ◽  
Urine Protein ◽  
Bence Jones Proteinuria

Lymphoplasmacytic stomatitis and gingivitis was diagnosed in an 8-year old female domestic shorthair. The cat had evidence of severe generalized inflammation of the oral cavity. Biopsy samples were evaluated and displayed a lichenoid, interface stomatitis which was predominantly lymphoplasmacytic. Serum protein electrophoresis confirmed a monoclonal gammopathy. Urine protein electrophoresis confirmed Bence-Jones proteinuria. Protein electrophoresis was used to diagnose monoclonal gammopathy (the production of a monoclonal immunoglobulin, or paraprotein, which is associated with a characteristic “M” protein spike on serum electrophoresis). Diseases associated with monoclonal gammopathy are similar in the dog and cat. Alkylating agent chemotherapy is used to rapidly reduce paraprotein concentrations in multiple myeloma. Multiple myeloma is the most common disorder associated with monoclonal gammopathy. This condition is less common in the cat, compared to the dog. This report examines the diagnosis and treatment of multiple myeloma in a cat presenting with severe stomatitis.

scholarly journals International Myeloma Working Group Recommendations for the Treatment of Multiple Myeloma–Related Bone Disease

2013 ◽  
Vol 31 (18) ◽  
pp. 2347-2357 ◽  
Author(s):  
Evangelos Terpos ◽  
Gareth Morgan ◽  
Meletios A. Dimopoulos ◽  
Matthew T. Drake ◽  
Suzanne Lentzsch ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Multiple Myeloma ◽  
Spinal Cord Compression ◽  
Bone Disease ◽  
Working Group ◽  
Cord Compression ◽  
Vertebral Compression Fractures ◽  
Bone Lesions ◽  
Published Data ◽  
International Myeloma Working Group

PurposeThe aim of the International Myeloma Working Group was to develop practice recommendations for the management of multiple myeloma (MM) –related bone disease.MethodologyAn interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations based on published data through August 2012. Expert consensus was used to propose additional recommendations in situations where there were insufficient published data. Levels of evidence and grades of recommendations were assigned and approved by panel members.RecommendationsBisphosphonates (BPs) should be considered in all patients with MM receiving first-line antimyeloma therapy, regardless of presence of osteolytic bone lesions on conventional radiography. However, it is unknown if BPs offer any advantage in patients with no bone disease assessed by magnetic resonance imaging or positron emission tomography/computed tomography. Intravenous (IV) zoledronic acid (ZOL) or pamidronate (PAM) is recommended for preventing skeletal-related events in patients with MM. ZOL is preferred over oral clodronate in newly diagnosed patients with MM because of its potential antimyeloma effects and survival benefits. BPs should be administered every 3 to 4 weeks IV during initial therapy. ZOL or PAM should be continued in patients with active disease and should be resumed after disease relapse, if discontinued in patients achieving complete or very good partial response. BPs are well tolerated, but preventive strategies must be instituted to avoid renal toxicity or osteonecrosis of the jaw. Kyphoplasty should be considered for symptomatic vertebral compression fractures. Low-dose radiation therapy can be used for palliation of uncontrolled pain, impending pathologic fracture, or spinal cord compression. Orthopedic consultation should be sought for long-bone fractures, spinal cord compression, and vertebral column instability.

scholarly journals New drugs and novel mechanisms of action in multiple myeloma in 2013: a report from the International Myeloma Working Group (IMWG)

Leukemia ◽  
2013 ◽  
Vol 28 (3) ◽  
pp. 525-542 ◽  
Author(s):  
E M Ocio ◽  
◽  
P G Richardson ◽  
S V Rajkumar ◽  
A Palumbo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Working Group ◽  
Mechanisms Of Action ◽  
New Drugs ◽  
International Myeloma Working Group
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