{"id":2125,"date":"2017-06-08T10:05:21","date_gmt":"2017-06-08T10:05:21","guid":{"rendered":"https:\/\/www.lalpathlabs.com\/blog\/?p=2125"},"modified":"2023-10-12T12:48:46","modified_gmt":"2023-10-12T07:18:46","slug":"an-overview-of-multiple-myeloma-test","status":"publish","type":"post","link":"https:\/\/www.lalpathlabs.com\/blog\/an-overview-of-multiple-myeloma-test\/","title":{"rendered":"An Overview of Multiple Myeloma Test"},"content":{"rendered":"

\"myeloma\"<\/p>\n

Problems get multiplied if they are not detected at the earliest.<\/strong><\/span><\/p>\n

Dr Lal PathLabs offers end-to-end solutions by providing a comprehensive range of Multiple Myeloma<\/span> tests<\/a>.<\/strong><\/p>\n

NICE 2016, GUIDELINES ON MULTIPLE MYELOMA<\/strong><\/span><\/p>\n

While performing a bone marrow aspirate and trephine biopsy to provide prognostic information:<\/p>\n

\u2022 Fluorescence In-situ Hybridization (FISH) on CD138-selected bone marrow plasma cells to identify the adverse risk abnormalities t(4;14), t(14;16), 1q gain, del(1p) and del(17p) (TP53 deletion). Use these abnormalities alongside International Staging System (ISS) scores to identify people with high-risk myeloma.
\n\u2022 Consider FISH on CD138-selected bone marrow plasma cells to identify the adverse risk abnormality t (14; 20), the standard risk abnormalities t (11; 14) and hyperdiploidy.
\n\u2022 Consider immunophenotyping of bone marrow to identify plasma cell phenotype and to inform subsequent monitoring.
\n\u2022 Consider immunohistochemistry (including Ki-67 staining and p53 expression) on the trephine biopsy to identify plasma cell phenotype and give an indication of cell proliferation to provide further prognostic information.
\n\u2022 Perform serum-free light-chain assay and use serum-free light-chain ratio to assess prognosis.<\/p>\n

KEY INVESTIGATIONS<\/span><\/strong><\/h3>\n

\"key<\/p>\n

\"multiple<\/p>\n

“Myeloma Defining Events (MDE) : Calcium >0.25 mmol\/L (>1 mg\/dL) higher than the upper limit of normal or >2.75 mmol\/L (>11 mg\/dL)<\/p>\n

\u2022 Renal insufficiency (creatinine >2 mg\/dL) (>177 prno1\/14 or creatinine clearance <40 mUmin
\n\u2022 Anemia (hemoglobin <10 g\/dL or hemoglobin >2 g\/dL below the lower limit of normal)
\n\u2022 One or more osteolytic bone lesions on skeletal radiography, CT or PET\/CT
\n\u2022 Clonal bone marrow plasma cells >6096
\n\u2022 Abnormal serum FLC ratio >100 (involved kappa) or s0.01(involved lambda)
\n\u2022 >1 focal lesions on MRI studies >5mm<\/p>\n

REFERENCES<\/strong><\/span><\/p>\n

1. Sonneveld, P. et al. Treatment of multiple myeloma<\/a><\/span> with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood 127, 2955-2962 (2016).<\/p>\n

2. Ghobrial, I. M. & Landgren, 0. How I treat smoldering multiple myeloma. Blood 124, 3380-3388 (2014).<\/p>\n

3. Moreau, P. et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 24, vi133\u2014vi137 (2013).<\/p>\n

4. Pratt, G. & Morris, T. c. Review of the NICE guidelines for multiple myeloma. Int. Jnl. Lab. Hem. 39, 3-13 (2017).<\/p>\n

5. Risk Stratification for Multiple Myeloma. ASCO Annual Meeting (2016). Available at: https:\/\/am.asco.org\/daily-news\/risk-stratification-multiple-myeloma (Accessed: 27th March 2017).<\/p>\n

6. Version 3.2017, 11\/28\/16 \u00a9 National Comprehensive Cancer Network, Inc. 2016.<\/p>\n