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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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Autores principales: Morawska, Marta, Dwilewicz-Trojaczek, Jadwiga, Stompór, Tomasz, Ligocki, Piotr, Stopiński, Marek, Sutkowski, Michał, Grząśko, Norbert, Kordecka, Anna, Kordecki, Mariusz, Jurczyszyn, Artur, Dytfeld, Dominik, Wróbel, Tomasz, Jamroziak, Krzysztof, Druzd-Sitek, Agnieszka, Walter-Croneck, Adam, Giannopoulos, Krzysztof
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966236/
https://www.ncbi.nlm.nih.gov/pubmed/36835883
http://dx.doi.org/10.3390/jcm12041345
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author Morawska, Marta
Dwilewicz-Trojaczek, Jadwiga
Stompór, Tomasz
Ligocki, Piotr
Stopiński, Marek
Sutkowski, Michał
Grząśko, Norbert
Kordecka, Anna
Kordecki, Mariusz
Jurczyszyn, Artur
Dytfeld, Dominik
Wróbel, Tomasz
Jamroziak, Krzysztof
Druzd-Sitek, Agnieszka
Walter-Croneck, Adam
Giannopoulos, Krzysztof
author_facet Morawska, Marta
Dwilewicz-Trojaczek, Jadwiga
Stompór, Tomasz
Ligocki, Piotr
Stopiński, Marek
Sutkowski, Michał
Grząśko, Norbert
Kordecka, Anna
Kordecki, Mariusz
Jurczyszyn, Artur
Dytfeld, Dominik
Wróbel, Tomasz
Jamroziak, Krzysztof
Druzd-Sitek, Agnieszka
Walter-Croneck, Adam
Giannopoulos, Krzysztof
author_sort Morawska, Marta
collection PubMed
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.
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spelling pubmed-99662362023-02-26 A Stepwise Screening Protocol for Multiple Myeloma Morawska, Marta Dwilewicz-Trojaczek, Jadwiga Stompór, Tomasz Ligocki, Piotr Stopiński, Marek Sutkowski, Michał Grząśko, Norbert Kordecka, Anna Kordecki, Mariusz Jurczyszyn, Artur Dytfeld, Dominik Wróbel, Tomasz Jamroziak, Krzysztof Druzd-Sitek, Agnieszka Walter-Croneck, Adam Giannopoulos, Krzysztof J Clin Med Protocol 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. MDPI 2023-02-08 /pmc/articles/PMC9966236/ /pubmed/36835883 http://dx.doi.org/10.3390/jcm12041345 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Protocol
Morawska, Marta
Dwilewicz-Trojaczek, Jadwiga
Stompór, Tomasz
Ligocki, Piotr
Stopiński, Marek
Sutkowski, Michał
Grząśko, Norbert
Kordecka, Anna
Kordecki, Mariusz
Jurczyszyn, Artur
Dytfeld, Dominik
Wróbel, Tomasz
Jamroziak, Krzysztof
Druzd-Sitek, Agnieszka
Walter-Croneck, Adam
Giannopoulos, Krzysztof
A Stepwise Screening Protocol for Multiple Myeloma
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 Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9966236/
https://www.ncbi.nlm.nih.gov/pubmed/36835883
http://dx.doi.org/10.3390/jcm12041345
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