Practical approach for internists to plasma cell neoplasms/monoclonal gammopathies

Authors

DOI:

https://doi.org/10.18041/2665-427X/ijeph.2.9909

Keywords:

monoclonal gammopathies, multiple myeloma

Abstract

Introduction: The concept of monoclonal gammopathies (GM) is widely known in medical literature and refers to the typical finding of a monoclonal spike in the gamma region on serum protein electrophoresis. Multiple myeloma (MM) is by far the most representative entity within the group and is the second most frequent cause of hematological malignancy.

Objective: To review the main clinical characteristics of monoclonal gammopathies, with emphasis on multiple myeloma.

Methods: Text written based on the magistral conference with the same title presented at the ACMI Valle - Universidad Libre Internal Medicine Congress.

Results: these multiple myeloma topics are discussed: history, pathophysiology, epidemiology, clinical scenarios for suspection, diagnosis, risk stratification and treatment; also we briefly discuss about other plasma cell neoplasms associated with multiple myeloma (light chain amyloidosis, Waldeström's macroglobulinemia, POEMS syndrome).

Conclusion: Multiple myeloma is the most representative entity within the group of monoclonal gammopathies and in general is the second most common cause of hematological malignancy; to know the main clinical characteristics of these pathologies and the clinical scenarios in which they should be suspected is essential to achieve an early diagnosis that favors better outcomes.

Downloads

Download data is not yet available.

References

Kaseb H, Durer C, Fazal S, Babiker HM. Plasma cell cancer. Treasure Island (FL): StatPearls Publishing; 2022.

Kyle RA, Steensma DP. History of multiple myeloma. Recent Results Cancer Res. 2011; 183: 3-23. DOI 10.1007/978-3-540-85772-3_1.

Diaz-Maquero JC. Historia del mieloma multiple. Rev Biomed. 2006; 17(3): 225-229. DOI 10.32776/revbiomed.v17i3.459

Abbas A, Lichtman A, Pillai S. Cellular and molecular inmunology. 10th Ed. Elsvier; 2021.

Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003: 78(1): 21-33. DOI 10.4065/78.1.21

Palimbo A, Anderson J. Multiple myeloma. N Engl J Med. 2011; 364: 1046-1060. DOI 10.1056/NEJMra1011442

Martinez Cordero H. Protocolo de manejo de pacientes con mieloma mùltiple. Instituto Nacional de Cancerologia de Colombia; 2020.

Martinez CH, Zapata MJ, Cubillos OL, Rico MA, Porras RA, Ospina IJ, et al. Multiple myeloma mortality incidence prevalence of disease - My Mind Study. Blood. 2020; 136(Supplement 1): 10–11. DOI 10.1182/blood-2020-142376

Kazandjian D. Multiple myeloma epidemiology and survival, a unique malignancy. Semin Oncol. 2016; 43(6): 676–681. DOI 10.1053/j.seminoncol.2016.11.004

Koshiaris C. Methods for reducing delays in the diagnosis of multiple myeloma. Int J Hematol Oncol. 2019; 8(1): IJH13. DOI 10.2217/ijh-2018-0014

Koshiaris C, Van den Bruel A, Oke JL, Nicholson BD, Shephard E, Braddick M, et al. Early detection of multiple myeloma in primary care using blood tests: a case-control study in primary care. Br J Gen Pract. 2018; 68(674): 586-593. DOI 10.3399/bjgp18X69835

Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos M-V, et al. International Myeloma Working Group updated the criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15(12): 538-548. DOI 10.1016/S1470-2045(14)70442-5

Mateos M-V, Hernández MT, Salvador C, de la Rubia J, de Arriba F, López-Corral L, et al. Lenalidomide plus Dexamethasone for High-Risk Smoldering Multiple Myeloma. N Engl J Med. 2013; 369(5): 438-447. DOI 10.1056/NEJMoa1300439

Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015: 33 (26): 2863–2869. DOI 10.1200/JCO.2015.61.2267

Devarakonda S, Efebera Y, Sharma N. Role of Stem Cell Transplantation in Multiple Myeloma. Cancers (Basel). 2021; 13(4): 863. DOI 10.3390/cancers13040863

Santamaria Alza Y, Vasquez G. Are chimeric antigen receptor T cells (CAR-T cells) the future in immunotherapy for autoimmune diseases? Inflamm Res. 2021; 70(6): 651-663. DOI 10.1007/s00011-021-01470-1

Rendo MJ, Joseph JJ, Phan LM, DeStefano CB. CAR T-Cell Therapy for Patients with Multiple Myeloma: Current Evidence and Challenges. Blood Lymphat Cancer. 2022; 12: 119-136. DOI 10.2147/BLCTT.S327016

Wechalekar AD, Gillmore JD, Hawkins PN. Systemic amyloidosis. Lancet. 2016; 387(10038): 2641-2654. DOI 10.1016/S0140-6736(15)01274-X

Vijay A, Gertz MA. Waldenström macroglobulinemia. Blood. 2007; 109(12): 5096 - 6103. DOI 10.1182/blood-2006-11-055012

Ali T, Qazilbash MH. POEMS syndrome: A multisystem clonal disorder. Eur J Haematol. 2021; 106(1): 14-18. DOI 10.1111/ejh.13514

Published

2022-12-30

Issue

Section

Congress ACMI

How to Cite

Practical approach for internists to plasma cell neoplasms/monoclonal gammopathies. (2022). Interdisciplinary Journal of Epidemiology and Public Health, 5(2), e-9909. https://doi.org/10.18041/2665-427X/ijeph.2.9909