Monitoring Monoclonal Gammopathies
Disease Monitoring
November 2009
Because physicians order both electrophoretic and nephelometric assays, we have tried to assess the variability of each assay during disease monitoring. In this study, we identified patients who had monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma, and who also had stable disease as well as a minimum of 4 assays over a period of 1 to 5 years. Both nephelometric and electrophoretic assays have comparable analytic CVs of 4% to 5%, and when we also include long-term biologic variability, the total CVs over time are between 8% to 10%. These numbers suggest that the International Myeloma Working Group recommendations of at least a 25% change in serum M-spike for a minimum response may be too conservative.
Disease Monitoring |
Jump to section:
- Introduction
- Slide Images
- International Myeloma Working Group: Disease Monitoring
- Serum Protein Electrophoresis and Immunofixation Electrophoresis
- Serum and Urine Protein Electrophoresis and Immunofixation Electrophoresis
- Methods for Monitoring Monoclonal Gammopathies: 2005 IMWG
- Methods for Monitoring Monoclonal Gammopathies
- Small IgG kappa M-spike
- Large IgG kappa M-spike
- Relationship of Serum Agarose Electrophoresis M-spike and Ig Quantitation1
- Disease Monitoring
- Monoclonal Gammopathies: Primary Systemic Amyloidosis
- Free Light Chain: Antibody Specificity
- FLC κ/λ Ratio: Disease Sensitivity2
- Methods for Monitoring Monoclonal Gammopathies
- International Myeloma Working Group: 2009 Guidelines for Disease Monitoring3
- Response Criteria for FLC4,5
- Receiver Operator Curve (ROC): % FLC Reduction vs. Overall Hematologic Response6
- International Myeloma Working Group: 2009 Guidelines for Disease Monitoring
- References
- Questions?
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