Laboratory procedures in the diagnosis and monitoring of multiple myeloma Journal Article

  


Author: Fleisher, M.
Article Title: Laboratory procedures in the diagnosis and monitoring of multiple myeloma
Abstract: Multiple myeloma is an incurable B-cell neoplasia which typically causes dysregulated production and clonal expansion of malignant plasma cells. Neoplastic transformation in multiple myeloma appears to be associated with nonrandom translocation of oncogenes to the IgH locus on 14q32 (1,2). But, the exact cause of multiple myeloma(MM) remains largely unknown. The diagnosis of MM is based on the demonstration of monoclonal immunoglobulin protein in blood and urine, elevated levels of plasma cells in the bone marrow and atypical lytic bone lesions. The first line evaluation in the diagnostic schema is the demonstration of M-protein banding by agarose gel protein electrophoresis. Immunofixation electrophoresis is used to demonstrate the clonal characteristics of MM in which clonality is about 55% IgG and 20% IgA. New technology permits detection of monoclonal free light chains associated with light chain MM, nonsecretory MM and amyloid disease (3,4). Monoclonal free light chain analysis is many times more sensitive than protein electrophoresis and is quantitative in comparison to immunofixation which is qualitative and prone to visual misinterpretation. The use of serum free light chain analysis has become an important diagnostic and prognostic parameter in B-cell diseases including MM, Waldenströms macroglobulinemia and light chain deposition disease (amyloidosis). The identification of an M-protein in serum, along with elevated levels of free light chains, are definitive markers of plasma cell dyscrasia. These parameters are representative of a quintessential tumor marker.
Keywords: gene translocation; human cell; conference paper; laboratory diagnosis; sensitivity analysis; diagnostic procedure; multiple myeloma; analytic method; gene locus; immunoglobulin; amyloidosis; waldenstroem macroglobulinemia; tumor marker; b lymphocyte; oncogene; immunoglobulin g; cancer cell; malignant transformation; m protein; qualitative analysis; immunoglobulin a; agar gel electrophoresis; plasma cell dyscrasia; monoclonal gammopathies; human; diagnosing multiple myeloma; m-protein detection; immunofixation electrophoresis; serum free light chain analysis
Journal Title: Journal of Clinical Ligand Assay
Volume: 26
Issue: 1
ISSN: 1081-1672
Publisher: Clinical Ligand Assay Society  
Date Published: 2003-01-01
Start Page: 50
End Page: 53
Language: English
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-0142072636&partnerID=40&md5=5fa18d941b7cca9835ccfa24a5dae382
Notes: Export Date: 25 September 2014 -- Source: Scopus