A Stepwise Screening Protocol for Multiple Myeloma
Background: Monoclonal gammopathies and multiple myeloma should be screened in the primary care setting. Methods: The screening strategy consisted of an initial interview supported with the analysis of basic laboratory test results and the increasing laboratory workload in the following steps was de...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/4/1345 |
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| author | Marta Morawska Jadwiga Dwilewicz-Trojaczek Tomasz Stompór Piotr Ligocki Marek Stopiński Michał Sutkowski Norbert Grząśko Anna Kordecka Mariusz Kordecki Artur Jurczyszyn Dominik Dytfeld Tomasz Wróbel Krzysztof Jamroziak Agnieszka Druzd-Sitek Adam Walter-Croneck Krzysztof Giannopoulos |
| author_facet | Marta Morawska Jadwiga Dwilewicz-Trojaczek Tomasz Stompór Piotr Ligocki Marek Stopiński Michał Sutkowski Norbert Grząśko Anna Kordecka Mariusz Kordecki Artur Jurczyszyn Dominik Dytfeld Tomasz Wróbel Krzysztof Jamroziak Agnieszka Druzd-Sitek Adam Walter-Croneck Krzysztof Giannopoulos |
| author_sort | Marta Morawska |
| collection | DOAJ |
| description | Background: Monoclonal gammopathies and multiple myeloma should be screened in the primary care setting. Methods: The screening strategy consisted of an initial interview supported with the analysis of basic laboratory test results and the increasing laboratory workload in the following steps was developed based on characteristics of patients with multiple myeloma. Results: The developed 3-step screening protocol includes evaluation of myeloma-related bone disease, two renal function markers, and three hematologic markers. In the second step, the erythrocyte sedimentation rate (ESR) and the level of C-reactive protein (CRP) were cross-tabulated to identify persons qualifying for confirmation of the presence of monoclonal component. Patients with diagnosed monoclonal gammopathy should be referred to a specialized center to confirm the diagnosis. The screening protocol testing identified 900 patients with increased ESR and normal level of CRP and 94 of them (10.4%) had positive immunofixation. Conclusions: The proposed screening strategy resulted in an efficient diagnosis of monoclonal gammopathy. The stepwise approach rationalized the diagnostic workload and cost of screening. The protocol would support primary care physicians, standardizing the knowledge about the clinical manifestation of multiple myeloma and the method of evaluation of symptoms and diagnostic test results. |
| first_indexed | 2024-03-11T08:38:59Z |
| format | Article |
| id | doaj.art-bd42a2aecce04986a5dbdbf29d722d77 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T08:38:59Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-bd42a2aecce04986a5dbdbf29d722d772023-11-16T21:18:17ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01124134510.3390/jcm12041345A Stepwise Screening Protocol for Multiple MyelomaMarta Morawska0Jadwiga Dwilewicz-Trojaczek1Tomasz Stompór2Piotr Ligocki3Marek Stopiński4Michał Sutkowski5Norbert Grząśko6Anna Kordecka7Mariusz Kordecki8Artur Jurczyszyn9Dominik Dytfeld10Tomasz Wróbel11Krzysztof Jamroziak12Agnieszka Druzd-Sitek13Adam Walter-Croneck14Krzysztof Giannopoulos15Experimental Hematooncology Department, Medical University of Lublin & Hematology Department, St. John’s Cancer Center, 20-093 Lublin, PolandDepartment of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Nephrology, Hypertension and Internal Medicine, University of Warmia and Mazury, 10-719 Olsztyn, PolandDepartment of Internal Diseases, Clinical Department of Rheumatology, 10th Military Research Hospital and Polyclinic IPHC in Bydgoszcz, 85-681 Bydgoszcz, PolandInternal Department, Geriatric Unit, John Paul II Western Hospital in Grodzisk Mazowiecki, 05-825 Grodzisk Mazowiecki, PolandCollege of Family Physicians in Poland, 00-209 Warsaw, PolandExperimental Hematooncology Department, Medical University of Lublin & Hematology Department, St. John’s Cancer Center, 20-093 Lublin, PolandHTA Registry, 30-552 Krakow, PolandHTA Registry, 30-552 Krakow, PolandPlasma Cell Dyscrasia Center, Department of Hematology, Faculty of Medicine, Jagiellonian University Medical College, 31-007 Krakow, PolandDepartment of Hematology, Poznan University of Medical Sciences, 60-512 Poznan, PolandDepartment of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wroclaw, PolandDepartment of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, 00-001 Warsaw, PolandDepartment of Haemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, PolandExperimental Hematooncology Department, Medical University of Lublin & Hematology Department, St. John’s Cancer Center, 20-093 Lublin, PolandBackground: Monoclonal gammopathies and multiple myeloma should be screened in the primary care setting. Methods: The screening strategy consisted of an initial interview supported with the analysis of basic laboratory test results and the increasing laboratory workload in the following steps was developed based on characteristics of patients with multiple myeloma. Results: The developed 3-step screening protocol includes evaluation of myeloma-related bone disease, two renal function markers, and three hematologic markers. In the second step, the erythrocyte sedimentation rate (ESR) and the level of C-reactive protein (CRP) were cross-tabulated to identify persons qualifying for confirmation of the presence of monoclonal component. Patients with diagnosed monoclonal gammopathy should be referred to a specialized center to confirm the diagnosis. The screening protocol testing identified 900 patients with increased ESR and normal level of CRP and 94 of them (10.4%) had positive immunofixation. Conclusions: The proposed screening strategy resulted in an efficient diagnosis of monoclonal gammopathy. The stepwise approach rationalized the diagnostic workload and cost of screening. The protocol would support primary care physicians, standardizing the knowledge about the clinical manifestation of multiple myeloma and the method of evaluation of symptoms and diagnostic test results.https://www.mdpi.com/2077-0383/12/4/1345monoclonal gammopathymultiple myelomascreening |
| spellingShingle | Marta Morawska Jadwiga Dwilewicz-Trojaczek Tomasz Stompór Piotr Ligocki Marek Stopiński Michał Sutkowski Norbert Grząśko Anna Kordecka Mariusz Kordecki Artur Jurczyszyn Dominik Dytfeld Tomasz Wróbel Krzysztof Jamroziak Agnieszka Druzd-Sitek Adam Walter-Croneck Krzysztof Giannopoulos A Stepwise Screening Protocol for Multiple Myeloma Journal of Clinical Medicine monoclonal gammopathy multiple myeloma screening |
| title | A Stepwise Screening Protocol for Multiple Myeloma |
| title_full | A Stepwise Screening Protocol for Multiple Myeloma |
| title_fullStr | A Stepwise Screening Protocol for Multiple Myeloma |
| title_full_unstemmed | A Stepwise Screening Protocol for Multiple Myeloma |
| title_short | A Stepwise Screening Protocol for Multiple Myeloma |
| title_sort | stepwise screening protocol for multiple myeloma |
| topic | monoclonal gammopathy multiple myeloma screening |
| url | https://www.mdpi.com/2077-0383/12/4/1345 |
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