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Simultaneous Evaluation of Serum Immunofixation Electrophoresis and Serum Free Light Chain Measurements Used in the Diagnosis of Monoclonal Gammopathy and Smoldering Multiple Myeloma of Uncertain Significance in the Presence of Risk Factors
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Original Article
VOLUME: 56 ISSUE: 1
P: 33-45
2023

Simultaneous Evaluation of Serum Immunofixation Electrophoresis and Serum Free Light Chain Measurements Used in the Diagnosis of Monoclonal Gammopathy and Smoldering Multiple Myeloma of Uncertain Significance in the Presence of Risk Factors

Acta Haematol Oncol Turc 2023;56(1):33-45
DOI: 10.5505/aot.2023.32650
İrem Öner 1
Fatih Sackan 2
Ali Ünal 3
1. Department Of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training And Research Hospital, Ankara, Turkey
2. Department Of Internal Diseases, Health Sciences University Konya City Hospital, Konya, Turkey
3. Department Of Hematology, Erciyes University Faculty Of Medicine Hospital, Kayseri, Turkey
4.
No information available.
No information available
Received Date: 2022-05-27T21:51:53
Accepted Date: 2023-04-03T07:13:19
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Abstract

INTRODUCTION

This study aimed to investigate the effectiveness of using serum free light chain (sFLC) together with traditional examination methods in diagnosing monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM), especially in patients with MG without hypercalcemia, renal dysfunction, anemia, and bone lesions (CRAB) symptoms, by eliminating the need for bone marrow biopsy (BMb).

METHODS

A total of 160 patients over 50 years of age with an ESR of 50 mm/h and above were included in the study. Serum immunofixation electrophoresis (sIFE) and sFLC levels of these patients were studied simultaneously. Sensitivity and specificity of the sIFE and sFLC for diagnosis of MGUS were estimated by ROC analysis.

RESULTS

MG was detected in 36 (22.5%) patients with sIFE and in 30 (18.7%) patients with sFLC of 160 patients included in the study. There was a total of 44 patients with MG detected by sIFE alone, sFLC alone, and both sIFE and sFLC. Bone marrow biopsy(bmb) was performed on 42 patients with MG who approved the bmb procedure. These patients were diagnosed MGUS, SMM and MM by using test results, bmb results, and clinical and laboratory data. The sensitivity of sIFE in the detection of MG was 82.5% and the specificity was 99.2% (p<0.001). sFLC had a sensitivity of 72.5% and a specificity of 99.2% (p0.001). When siFE and sFLC were performed simultaneously, the sensitivity was 100% and the specificity was 98.3% (p<0.001).

DISCUSSION AND CONCLUSION

Simultaneous monitoring of sIFE and sFLC, which is both non-invasive and with the opportunity to achieve results in less time without BM bx, may be sufficient and reliable in the diagnosis and follow-up of MGUS in the detection of MGs and especially in asymptomatic patients.