We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byDrew Weston
Modified over 2 years ago
MGUS (interpreting the test you didnt order) Family Medicine Review Course 2011 Christian Cable, MD, FACP
What is the laboratory abnormality? 10-3 = 7 Whats in there?
What comprises the blood?
Whats in blood... Cellular (bone marrow) – RBCs – Platelets – WBCs Plasma (liver) – Water – Proteins Albumin Antibodies Clotting factors
Proteins in the Blood?
Brainstorm As many globins as you can think of...
Tell me more about antibodies
What is the correct test?
SPEP/SIEP SPEP qualitative (is it there?) SIEP quantitative (how much, which one?)
Copyright ©2001 American Society of Hematology. Copyright restrictions may apply. Lazarchick, J. ASH Image Bank 2001;2001:100185 Figure 8. Immunofixation electrophoresis showing a monoclonal IgA lambda light chain restricted band
Greek to me (I)... Gamma - - region in electrophoretic mobility Pathy - - disease or condition
Greek to me (II)... Clonal - - type Mono - - one Poly - - many (much)
Differentiate Polyclonal from Monoclonal
What is normal?
Polyclonal gammopathy - -significance Think of an elevated ESR What could cause that?
Is polyclonal gammopathy a plasma cell disorder?
Monoclonal gammopathy - - determined significance
New Myeloma Classification
Copyright ©2002 American Society of Hematology. Copyright restrictions may apply. Schrier, S. ASH Image Bank 2002;2002:100514 Figure 2. This is a bone marrow aspirate from a patient with multiple myeloma showing the abnormal accumulation of malignant plasma cells
Copyright ©2001 American Society of Hematology. Copyright restrictions may apply. Lazarchick, J. ASH Image Bank 2001;2001:100185 Figure 11. Skull x-ray showing multiple lytic areas
Monoclonal gammopathy - - undetermined significance
3% of population over 50 twice that prevalence African Americans
Defined M-spike < 3 g/dL absence of CRAB symptoms (at least those attributable to MM) - - tricky with pre-existing renal disease! Bone Marrow involvement <10% with clonal plasma cells
How to evaluate CBC, Creatinine, Calcium, SPEP/SIEP Skeletal survey (plain films)
When to refer
Higher risk non-Ig G (IgA & Ig M) African American total M spike: >1.5 g/dL
Why follow? Over 20 years: 1% per year turn into either Multiple Myeloma or another blood cancer Double that risk for non-IgG subtypes and African American patients
How do you follow it? Id like to help follow higher risk patients. Lower risk: – re-test in 6 months then annually
SIEP 1.6 g/dL IgA kappa
Recommendations referral bone marrow biopsy
Donna E. Reece, M.D. Princess Margaret Hospital 23 October 2010 MYELOMA CANADA CONFERENCE.
Plasma cell disorders Dr. hassanali vahedian ardakani Medical oncologist hematologist 2013.
Long-Term Biological Variation of Serum Protein Electrophoresis M-Spike, Urine M- Spike, and Monoclonal Serum Free Light Chain Quantification: Implications.
Plasma cell Disorders S. Sami Kartı, MD, Prof.. Plasma cells Terminally differentiated cells of B- lymphocyte lineage Produce antibodies Normal.
Diagnosis of Paraprotein Diseases CLS 404 Immunology Protein Abnormalities.
PLASMA CELL DYSCRASIAS Monoclonal gammopathy of uncertain significance (MGUS) Idiopathic Associated with other diseases (autoimmune, infectious, non-heme.
Tabuk University 1 3 rd Year – Level 5 – AY Faculty of Applied Medical Sciences Department Of Medical Lab. Technology.
Multiple Myeloma Definition: B-cell malignancy characterised by abnormal proliferation of plasma cells able to produce a monoclonal immunoglobulin ( M.
Multiple Myeloma Definition: B-cell malignancy characterised by abnormal proliferation of plasma cells able to produce a monoclonal immunoglobulin (M protein)
Jesse C James MD AM Report May 7, Proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein Malignant.
1.Defining Plasma cell disorders/Multiple Myeloma 2.Identification of different plasma cell disorders. 3.Diagnosis and workup for plasma cell disorders/Multiple.
Clinical interpretation of Serum Free Light Chain assays 22 Feb 2013 Dr. Eric Chan Consultant Immunologist Queen Mary Hospital Hong Kong.
Objectives To introduce the terminology used in describing the plasma cells neoplasm. To explain the physiology of the normal cells & the pathological.
Plasma cell dyscrasias. Multiple Myeloma By Dr. Muna A. Kashmool.
Serum protein electrophoresis is an easy method of separating serum proteins based on their net charge, size, and shape. A small amount of serum is.
Multiple Myeloma Morning Report July 21, 2009 Lindsay Kruska.
Understanding Serum Free Light Chain (Freelite®) and Heavy Chain-Light Chain (Hevylite®) Tests Judith A. Finlay Ph.D. Director of Scientific Affairs The.
Introduction to Myeloma: Diagnosis, Treatment, Risk Factors and Prevalence Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Alan Bryce, MD.
Paraprotein Diseases CLS 404 Immunology Protein Abnormalities.
Justin A. Crocker. 1 of the monoclonal gammopathies Neoplastic proliferation of immunoglobulin producing plasma cells (single clone), often resulting.
Electrophoresis Principle: –The movement of charged molecules in an electric field –The rate of migration is dependent on the net electrical charge of.
Chapter 21 Monoclonal Gammopathies Wu Jianmin. 1.Which Patients Should be Evaluated for the Presence of an M-Protein 2.What Types of Specimens Should.
Date of download: 5/31/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Multiple Myeloma Precursor Disease JAMA. 2010;304(21):
FAST TRACK REFERRALS Haematology Dr.V Tandon Consultant Haematologist
IMMUNOCHEMISTRY PROFILES Dr. Thomas Williams. TESTS DISEASES CASES.
Dr. Nitin Inamdar Department of Biochemistry Tata Memorial Center, Parel, Mumbai.
Serum Electrophoresis AND IMMUNOFIXATION june 2013 Dr. Nitin A Inamdar Department of Biochemistry Tata Memorial Center
M. Multiple Myeloma Malignant proliferation of plasma cells. Malignant proliferation of plasma cells. Normal plasma cell form Ig which contain heavy and.
Epidemiology 12,000 deaths in United States per year Median age of diagnosis is 65 years Two-fold more common in African-Americans than Caucasians Higher.
Terry Kotrla, MS, MT(ASCP)BB Topic 3 Autoimmunity Part 8 Immunoproliferative Diseases.
Support for pesticides playing a role in onset of multiple myeloma September 10, 2014 Ola Landgren, M.D., Ph.D. Chief, Myeloma Service Memorial Sloan-Kettering.
MULTIPLE MYELOMA (MM). CASE STUDY – MULTIPLE MYELOMA 74 year old BF presents to ED Fatigue, pain in spinal column, less frequent urination with dark color,
Tumor Markers Michael A. Pesce, PhD Department of Pathology Columbia-Presbyterian Medical Center.
Cancer Among Native Americans in Arizona and New Mexico Data Provided by Arizona Cancer Registry at the Arizona Department of Health Services and the New.
Evaluation of Anemia By Dr. Stephen Szabo. Relevant Lab Parameters Primary Complete Blood Count Complete Blood Count RBC count RBC count MCV MCV Hgb Hgb.
Show and Tell FIRM B - RED. Our team Dr. Clarke & Dr. Vargas Shinoj & Arvind Jacob & Muneeza Chloe, Lauren & Njiye.
Multiple Myeloma March 13, 2012 Suzanne R. Fanning, DO Greenville Health System.
CONCEPT MAP CONCEPT MAP. 42 y/o male, CC: EDEMA ON BILATERAL EXTREMITIES. Diagnosed with a benign cystic lesion 8 yrs ago S/Sx: BONE PAINS, EASY FATIGUABILITY.
Dr A. Mousavi. 15 % of all malignant white cell diseases 1% of all cancer deaths Group of lymphoid neoplasms of terminally differentiated B-cells.
Multiple Myeloma Serena Ezzeddine Morning Report May 30, 2009.
1 Coagulation : Clinical issues Dr. M.B. Agarwal, MD, MNAMS Head, Dept of Haematology, Bombay Hospital Inst of Med Sc, Mumbai 4 th Basic Haemato-Pathology.
Biological functions transport –albumin –transferin –ceruloplasmin –haptoglobin oncotic pressure regulation coagulation immunity.
O THER MALIGNANT LYMPHOPROLIFERATIVE DISORDERS The lymphomas and plasma cell problems.
Cancer Education Day Approach to Paraproteinemia or Why did I order that SPE?#! May 13, 2016 Dr Sindu Kanjeekal MD FRCPC Hematology and Medical Oncology.
Early Reduction of Serum-Free Light Chains Associates with Renal Recovery in Myeloma Kidney Sophina Hissaund FY2.
Serum Free Light Chains Should Be the Target of Response Evaluation in Light Chain Multiple Myeloma Rather Than Urines: Results from the IFM/DFCI 2009.
Hevylite®: a New Serum Test for Assessing Patients with Multiple Myeloma Judith A. Finlay, Ph.D. Director of Scientific Affairs The Binding Site, Inc.
Immune response against tumors. Tumor antigens Tumor-speciphic antigens – new antigens which develop in tumor cells. Tumor associated antigens – „normal“
© 2017 SlidePlayer.com Inc. All rights reserved.