Biochemical profile of multiple myeloma about 50 cases

Multiple myeloma (MM) is a clonal proliferation of plasma cells invading the bone marrow and secreting monoclonal immunoglobulin. In order to study the epidemiological and biological and biochemical characteristics of MM, we carried out a retrospective work on a cohort of 50 cases collected at the Avicenna Military Hospital in Marrakesh, during a period of 5 years (from January 2013 to December 2017). Our study included 32 men (64%) and 18 women (36%), with an average age of 60.6 years, with extremes at 44 and 87 years. The circumstances of discovery were dominated by bone pain and alteration in general condition, which are revealing in more than 65% of cases. Biologically: the sedimentation rate was accelerated in 86% of cases, a monoclonal peak appearance was revealed on serum proteins electrophoresis in 88%of cases, most often located in the γ zone (64%), a predominance of the Ig G isotype (64%), and kappa light chains in 60% of cases, Bence Jones protein (BJP) was found in 7 patients, i.e. 14% of cases, and plasmacytosis over 10% was found on the myelograms in 90 % of cases.

A rare case of plasmacytoma of mandible revealing plasma cell myeloma

Multiple myeloma (MM) is a malignant proliferation of plasma cells with multiple foci. Plasmacytoma is a solitary plasma cell neoplasm involving a single bone. The most commonly involved bone is vertebra. Jaw bones are rarely involved as a first bone as they have lesser hematopoietic marrow. A solitary plasmacytoma may progress to multiple myeloma within few months to year. We present a case of a swelling of mandible that on further investigations confirmed the diagnosis of multiple myeloma. We have discussed the course of treatment given and its prognosis. Keywords: multiple myeloma; plasmacytoma of jaw; bence jones Protein; abnormal plasma cells; CD138.

Comparison of 24-hour versus random urine samples for determination and quantification of Bence Jones protein in a South African population

Background: The International Myeloma Working Group and College of American Pathologists recommend a 24-h urine collection to determine the Bence Jones protein (BJP) excretion level for monitoring treatment response in patients with multiple myeloma (MM). There are several issues related to sample collection and the method is prone to inaccuracy.Objective: This study compared measured 24-h to random urine collections for the quantitation of BJP in a South African population.Methods: Sixty-six patients with MM submitted random urine samples with their routine 24-h urine collection from April 2016 – March 2018. Measured 24-h urine BJP was compared to two estimated 24-h BJP excretions calculated as follows: Estimation 1 (E1): Estimated 24-h BJP (mg/24 h) = Urine BJP/Creatinine ratio (mg/mmol) × 10. Estimation 2 (E2): Estimated 24-h BJP (mg/24 h) = Urine BJP/Creatinine ratio (mg/mmol) × 15 mg/kg for women or × 20 mg/kg for men.Results: Correlation of estimation equations E1 and E2 to the measured 24-h urine BJP was 0.893. Patients showed no difference in classification of treatment response using either the E1 or E2 estimation equations when compared to the measured 24-h urine BJP results.Conclusion: This study demonstrates that the estimated 24-h BJP shows a high degree of correlation with the measured 24-h BJP and can likely be used to monitor treatment response in South African patients with MM.

Primary Cutaneous Plasmacytosis with Calcinosis: A Rare Case Report

Primary cutaneous plasmacytosis is a rare disorder. Cases have been mostly reported from Japan. Here, a rare case of cutaneous plasmacytosis with calcium deposits was reported from southern part of India. A 47-year-old male patient presented with solitary asymptomatic nodule on the left leg present for two decades. Skin biopsy showed sheets of plasma cells in mid-dermis with bony trabeculae extending upto subcutis which was unremarkable. Serum electrophoresis did not reveal any M band and Bence Jones protein was absent in urine. Radiograph of the left leg showed focal lesion with calcific areas in soft tissue shadow with probability of calcification. Novelty of the case lies in its rare clinical presentation in this population with histopathological documentation.

Does the Sea Star Discriminate Bence - Jones protein From Rat Igg as Antigens?

Immunocompetent cells were described in the sea star Asterina gibbosa: they recognize specifically various antigens as HRP (Horse-radish peroxydase) ,Alkalin phosphatase, trypsin ....On the other hand when certain Asterina gibbosa were immunized with Bence-Jones protein , other ones with Rat IGG: a crossed immune reaction occurs. The potential sea star immune system is not broad enough to detect such antigens.

Giant Solitary Plasmacytoma of Skull: A Case Report

Plasmacytoma is a tumor arising from plasma cell, which mainly grows within soft tissue or within axial skeleton, when it is present as a discreet solitary mass it is called as solitary plasmacytoma & it is rare, we report a 46 years male, presented to us with the complaints of painless swelling in the left frontoparietal region which is about 8.6x6.5cm in diameter, Magnetic resonance imaging revealed an extra axial mass in fronto parietal region with overlying bone destruction mimicking meningioma with bony erosion, we did frontoparietal craniectomy and complete resection of tumor with bony margin subsequently cranioplasty was also done, histopathology of which revealed plasmacytoma,after that we did urinary bence jones protein which was negative. Bang. J Neurosurgery 2020; 10(1): 106-110

Bence-Jones Protein, Rat IGG, H.R.P, Alkaline Phosphatase, Bovine Serum Albumine used as Antigens in the Immune Response of the Sea Star.

Immunocompetent cells were described in the sea star Asterina gibbosa: they recognize specifically various antigens. In the present work, Asterina gibbosa were immunized with Bence-Jones protein, other ones with Rat IGG, at last certain with H.RP (Horse-radish Peroxydase) and the last ones with Alkaline Phosphatase: a crossed immune reaction occurs between Rat IGG and B.J protein, but not between B.J and H.R.P not between Rat IGG and H.R.P and not between Alkaline Phosphatase and B.J, not between Alkaline Phosphatase and Rat IGG, used as antigens.

Historical perspectives in clinical pathology: Bence Jones protein—early urine chemistry and the impact on modern day diagnostics

This is the third in the series of historical articles dealing with developments in clinical pathology. Bence Jones proteins are immunoglobulin light chains found in excessive quantities in urine in multiple myeloma and are believed to be one of the first tumour markers ever discovered . Dr Henry Bence Jones is credited with the discovery of this protein in 1847 that bears his name and he can also be regarded as the first chemical pathologist/clinical chemist. Since then, numerous advances and refinements have been made in the measurement and detection of urine light chain proteins which have resulted in the current sensitive serum free light chain assays used today.