scholarly journals DETERMINATION OF PARAPROTEIN IN SERUM AND URINE BY ELECTROPHORESIS FOR DIAGNOSING MULTIPLE MYELOMA (MM), EXPERIENCES FROM THE PHF UNIVERSITY CLINIC OF HEMATOLOGY FOR THE PERIOD FROM 2015 TO 2017

2019 ◽  
Vol 34 (4) ◽  
pp. 895-901
Author(s):  
Bosko Gjorgjievski ◽  
Dino Karpicarov ◽  
Biljana Gjorgjeska
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Bone Cancer ◽  
Study Data ◽  
World Health ◽  
Blood Calcium ◽  
Health Organization ◽  
Serum And Urine

Introduction: Multiple myeloma is a clonal disorder characterized by the proliferation of mature B cells (plasma cells) in the bone marrow i.e. the appearance of monoclonal immunoglobulin fraction (M component, paraprotein) in the serum or occasionally only during electrophoresis, in the urine. Generally, multiple myeloma is the most common primary bone cancer which can be defined as a malignant tumor of the bone marrow. Regarding the benign form (MGUS, monoclonal gammopathy of undetermined significance), it should be noted that it is about 100 times more common than the myeloma. In order to diagnose this disease, serum and urine are examined by electrophoresis because this technique firstly enables the separation of the proteins and then the detection of the desired group of proteins, in the specific case, the paraprotein group. However, the presence of such proteins in serum or urine is not always a sign for multiple myeloma, so in order to diagnose this disease, additional tests need to be done. These tests include: determination of the number of blood cells, determination of the level of blood calcium, determination of the level of urea and creatinine, determination of the percentage of plasma cells in the bone marrow. Besides these tests, the usual additional test includes detection of β–2–microglobulin, which is another protein that can be produced by multiple myeloma cells.Aims of the study: Overview of the diagnosis of multiple myeloma by determination of the paraprotein in serum or urine by electrophoresis; Determination of the prevalence of multiple myeloma in patients on the territory of the Republic of N. Macedonia from 2015 to 2017; Analysis of the obtained data in relation to the gender and the age of the patients.Materials and methods: For the purpose of this study, data obtained from multiple myeloma patients, diagnosed and treated at the PHF University Clinic of Hematology, were analyzed. The data were collected over a period of three years (from 2015 to 2017). The study included patients over 40 years of age. The entire research was done in the laboratory of PHF University Clinic of Hematology.Results: According to the research, 19 patients with multiple myeloma were registered in 2015, 22 patients with multiple myeloma were registered in 2016 and 25 patients with multiple myeloma were registered in 2017. In terms of gender, this disease is more common in men and in terms of age, the same disease is most prevalent in patients between 70 and 90 years of age.Conclusion: The incidence of multiple myeloma is approximately 5 to 7 patients per 100,000 persons annually. The disease data obtained in this study are identical to those of the World Health Organization (WHO). In most patients who were diagnosed with multiple myeloma, renal dysfunction was also observed.

An Intact Immunoglobulin IgAλ Multiple Myeloma Patient Exhibiting Light Chain Escape

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5008-5008
Author(s):  
Maria Kraj ◽  
Barbara Kruk ◽  
Krzysztof Warzocha ◽  
Andrzej Szczepinski ◽  
Kelly Endean ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Light Chain ◽  
Plasma Cells ◽  
Induction Treatment ◽  
Mild Renal Impairment ◽  
Multiple Myeloma Patient ◽  
Monoclonal Protein ◽  
Serum And Urine

Abstract Abstract 5008 A 48 year old man was referred to the Institute of Hematology and Transfusion Medicine, Warsaw, Poland in April 2008 with anemia (Hemoglobin; 10. 4 g/dl) and mild renal impairment (eGFR; 75. 4 mL/min/1. 73m2). An initial diagnostic monoclonal protein screen (serum protein electrophoresis (SPE), serum immunofixation electrophoresis (IFE) and serum free light chain (FLC) analysis) revealed an IgAλ monoclonal protein (0. 8g/dL) with monoclonal serum FLC and an abnormal serum FLC κ/λ ratio (0. 0001; RI, 0. 26–1. 65). A bone marrow biopsy at that time confirmed 60% involvement of monoclonal λ - restricted plasma cells; a bone survey did not detect any osteolysis. The patient was diagnosed with multiple myeloma (MM) (ISS stage I, Durie and Salmon stage IA) and was initially treated with 6 cycles of vincristin, doxorubicin and dexamethasone (VAD). The patient responded well to the induction treatment and subsequently underwent a successful autologous stem cell transplantation (ASCT). The patient was monitored for 3 years subsequent to the ASCT with both serum and urine electrophoresis, serum FLC analysis (Freelite) and heavy chain/light chain (HLC) immunoassays (Hevylite). Sixteen months following the ASCT the dFLC (involved λ FLC– uninvolved κ FLC) concentration began to increase, the FLC κ/λ ratio became abnormal with a trace of λ Bence Jones protein (BJP) detected by urine IFE. However, both SPE and IFE were normal and the HLC ratio (IgAλ/IgAκ) was within the normal range. During the next 9 months the dFLC continued to increase and a λ BJP could now be clearly detected on the urine IFE. 27 months following the ASCT the patient sustained a pathological fracture of the tibiae and was referred to our centre 4 months later. At this point, the dFLC concentration was highly elevated (3168 mg/L) with a λ BJP detectable by both serum and urine IFE. However, there was no detectable monoclonal intact immunoglobulin by serum IFE or HLC analysis, indicating disease relapse by a separate FLC clone; referred to as light chain escape (LCE). A bone marrow biopsy revealed 15% involvement of λ restricted plasma cells; this time a bone survey identified osteolysis. The patient was diagnosed with progression of multiple myeloma and received 6 cycles of bortezomib, cyclophosphamide and dexamethasone (VCD regimen). He responded well to treatment and 3 years following the ASCT achieved a CR as indicated by a normalized κ/λ FLC ratio, negative immunofixation with 1–3% bone marrow plasma cells. The patient is now well and able to continue with normal life. In this case study the increase in the dFLC levels was the first indication of disease progression and highlights the importance of monitoring intact immunoglobulin MM patients with serum FLC immunoassays for early detection of LCE. Disclosures: Endean: The Binding Site Group Ltd: Employment. Harding:Binding Site: Employment.

scholarly journals The importance of bone marrow examination in determining complete response to therapy in patients with multiple myeloma

Blood ◽  
2009 ◽  
Vol 114 (13) ◽  
pp. 2617-2618 ◽  
Author(s):  
Cheng E. Chee ◽  
Shaji Kumar ◽  
Dirk R. Larson ◽  
Robert A. Kyle ◽  
Angela Dispenzieri ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Light Chain ◽  
Plasma Cells ◽  
Complete Response ◽  
Free Light Chain ◽  
Response To Therapy ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Serum And Urine

Abstract The current definition of complete response in multiple myeloma includes a requirement for a bone marrow (BM) examination showing less than 5% plasma cells in addition to negative serum and urine immunofixation. There have been suggestions to eliminate the need for BM examinations when defining complete response. We evaluated 92 patients with multiple myeloma who achieved negative immunofixation in the serum and urine after therapy and found that 14% had BM plasma cells more than or equal to 5%. Adding a requirement for normalization of the serum-free light chain ratio to negative immunofixation studies did not negate the need for BM studies; 10% with a normal serum-free light chain ratio had BM plasma cells more than or equal to 5%. We also found that, on achieving immunofixation-negative status, patients with less than 5% plasma cells in the BM had improved overall survival compared with those with 5% or more BM plasma cells (6.2 years vs 2.3 years, respectively; P = .01).

Bone disease as the first manifestation of systemic AL-amyloidosis

2020 ◽  
Vol 92 (7) ◽  
pp. 85-89
Author(s):  
L. P. Mendeleeva ◽  
I. G. Rekhtina ◽  
A. M. Kovrigina ◽  
I. E. Kostina ◽  
V. A. Khyshova ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Disease ◽  
Plasma Cells ◽  
Interventricular Septum ◽  
Bone Destruction ◽  
Amyloid Deposition ◽  
Bone Lesions ◽  
Al Amyloidosis ◽  
Linear Type

Our case demonstrates severe bone disease in primary AL-amyloidosis without concomitant multiple myeloma. A 30-year-old man had spontaneous vertebral fracture Th8. A computed tomography scan suggested multiple foci of lesions in all the bones. In bone marrow and resected rib werent detected any tumor cells. After 15 years from the beginning of the disease, nephrotic syndrome developed. Based on the kidney biopsy, AL-amyloidosis was confirmed. Amyloid was also detected in the bowel and bone marrow. On the indirect signs (thickening of the interventricular septum 16 mm and increased NT-proBNP 2200 pg/ml), a cardial involvement was confirmed. In the bone marrow (from three sites) was found 2.85% clonal plasma cells with immunophenotype СD138+, СD38dim, СD19-, СD117+, СD81-, СD27-, СD56-. FISH method revealed polysomy 5,9,15 in 3% of the nuclei. Serum free light chain Kappa 575 mg/l (/44.9) was detected. Multiple foci of destruction with increased metabolic activity (SUVmax 3.6) were visualized on PET-CT, and an surgical intervention biopsy was performed from two foci. The number of plasma cells from the destruction foci was 2.5%, and massive amyloid deposition was detected. On CT scan foci of lesions differed from bone lesions at multiple myeloma. Bone fragments of point and linear type (button sequestration) were visualized in most of the destruction foci. The content of the lesion was low density. There was no extraossal spread from large zones of destruction. There was also spontaneous scarring of the some lesions (without therapy). Thus, the diagnosis of multiple myeloma was excluded on the basis based on x-ray signs, of the duration of osteodestructive syndrome (15 years), the absence of plasma infiltration in the bone marrow, including from foci of bone destruction by open biopsy. This observation proves the possibility of damage to the skeleton due to amyloid deposition and justifies the need to include AL-amyloidosis in the spectrum of differential diagnosis of diseases that occur with osteodestructive syndrome.

scholarly journals A review of current knowledge of myeloproliferative disorders in the horse

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Katy Satué ◽  
Juan Carlos Gardon ◽  
Ana Muñoz
Keyword(s):  
Bone Marrow ◽  
Myeloid Leukemia ◽  
Current Knowledge ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Disorders ◽  
World Health ◽  
Chronic Granulocytic Leukemia ◽  
Current State ◽  
Multiple Cell ◽  
Health Organization

AbstractMyeloid disorders are conditions being characterized by abnormal proliferation and development of myeloid lineage including granulocytes (neutrophils, eosinophils and basophils), monocytes, erythroids, and megakaryocytes precursor cells. Myeloid leukemia, based on clinical presentation and proliferative rate of neoplastic cells, is divided into acute (AML) and myeloproliferative neoplasms (MPN). The most commonly myeloid leukemia reported in horses are AML-M4 (myelomonocytic) and AML-M5 (monocytic). Isolated cases of AML-M6B (acute erythroid leukemia), and chronic granulocytic leukemia have also been reported. Additionally, bone marrow disorders with dysplastic alterations and ineffective hematopoiesis affecting single or multiple cell lineages or myelodysplastic diseases (MDS), have also been reported in horses. MDSs have increased myeloblasts numbers in blood or bone marrow, although less than 20%, which is the minimum level required for diagnosis of AML. This review performed a detailed description of the current state of knowlegde of the myeloproliferative disorders in horses following the criteria established by the World Health Organization.

scholarly journals Study of Well Waters from High-Level Natural Radiation Areas in Northern Vietnam

2021 ◽  
Vol 18 (2) ◽  
pp. 469
Author(s):  
Van-Hao Duong ◽  
Thanh-Duong Nguyen ◽  
Miklos Hegedus ◽  
Erika Kocsis ◽  
Tibor Kovacs
Keyword(s):  
Natural Radionuclide ◽  
World Health ◽  
Natural Radiation ◽  
Lifetime Cancer Risk ◽  
Northern Vietnam ◽  
Health Organization ◽  
High Level ◽  
Radiological Hazard Indices ◽  
Well Waters

The determination of natural radionuclide concentrations plays an important role for assuring public health and in the estimation of the radiological hazards. This is especially true for high level radiation areas. In this study, 226Ra, 228Ra and 238U concentrations were measured in well waters surrounding eight of the high-level natural radiation areas in northern Vietnam. The 226Ra, 228Ra and 238U activity concentrations vary from <1.2 × 10−3–2.7 (0.46), <2.6 × 10−3–0.43 (0.07) and <38 × 10−3–5.32 Bq/L (0.50 of median), respectively. 226Ra and 238U isotopes in most areas are in equilibrium, except for the DT-Thai Nguyen area. The calculated radiological hazard indices are generally higher than WHO (World Health Organization) recommendations. Average annual effective dose and excess lifetime cancer risk values due to drinking well water range from to 130 to 540 μSv/year and 7.4 × 10−6 to 3.1 × 10−5, respectively.

scholarly journals HCV Detection, Discrimination, and Genotyping Technologies

Sensors ◽  
2018 ◽  
Vol 18 (10) ◽  
pp. 3423 ◽  
Author(s):  
Shrikant Warkad ◽  
Satish Nimse ◽  
Keum-Soo Song ◽  
Taisun Kim
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
World Health ◽  
Clinical Samples ◽  
Infected People ◽  
Advantages And Disadvantages ◽  
Highly Sensitive ◽  
The World ◽  
Health Organization

According to the World Health Organization (WHO), 71 million people were living with Hepatitis C virus (HCV) infection worldwide in 2015. Each year, about 399,000 HCV-infected people succumb to cirrhosis, hepatocellular carcinoma, and liver failure. Therefore, screening of HCV infection with simple, rapid, but highly sensitive and specific methods can help to curb the global burden on HCV healthcare. Apart from the determination of viral load/viral clearance, the identification of specific HCV genotype is also critical for successful treatment of hepatitis C. This critical review focuses on the technologies used for the detection, discrimination, and genotyping of HCV in clinical samples. This article also focuses on advantages and disadvantages of the reported methods used for HCV detection, quantification, and genotyping.

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