Monoclonal Gammopathy

Aka: Monoclonal Gammopathy, Plasma Cell Disorder

advertisement

II. Types: Plasma Cell Peripheral Disorder

  1. Common
    1. Monoclonal Gammopathy of Undetermined Significance (MGUS)
  2. Uncommon
    1. Waldenstrom Macroglobulinemia
    2. Cardiac Amyloidosis
    3. B-Cell Non-Hodgkin Lymphoma
  3. Rare
    1. Plasmacytoma
    2. Plasma Cell Leukemia

III. Screening: Indications

  1. Normocytic Anemia
  2. Non-age appropriate bone loss
  3. Proteinuria
  4. Peripheral Neuropathy
  5. Increased total Protein

IV. Evaluation

  1. Establish Monoclonal Protein (M Protein) is present
    1. Obtain Serum Protein Electrophoresis (SPEP)
    2. Urine Protein electrophoresis (UPEP)
  2. Characterize the M Protein with immunofixation
    1. Clonal Bone Marrow plasma cell percentage 60% or higher in Multiple Myeloma
  3. Evaluate CRAB Criteria (end-organ injury consistent with Multiple Myeloma)
    1. Calcium
      1. Hypercalcemia (Serum Calcium >11 mg/dl)
    2. Renal Insufficiency
      1. Serum Creatinine >2 mg/dl (GFR <40 ml/min)
    3. Anemia
      1. Hemoglobin < 10
    4. Bony Lesions
      1. One or more osteolytic lesions on XRay, CT or PET CT
  4. Evaluate plasma free light chains
    1. Free Light Chain Ratio (FLC Ratio, involved to uninvolved ratio 100 of higher)

V. References

  1. Thompson (2017) Monoclonal Gammopathy, Mayo Clinical Reviews, Rochester, MN

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Monoclonal Gammopathy." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Topics in Bone Marrow Disorders

advertisement