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Monitoring Monoclonal Gammopathies



Disease Monitoring

Slide 11

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

 


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