The role of serum protein electrophoresis in the detection of multiple myeloma: an experience of a corporate hospital

Abstract

Background: Multiple Myeloma (M.M) is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells, secreting abnormal immunoglobulin causing monoclonal gammopathy which can be detected by the presence of M protein in serum and urine electrophoresis.

Aim: To detect and quantify monoclonal gammopathy in suspected cases of multiple myeloma and to differentiate them from benign conditions, because of the vast difference between their prognosis and management.

Method: Serum samples from 150 suspected cases of M.M were subjected to serum protein electrophoresis on cellulose acetate strip. M band detected visually and estimation of M protein was done by densitometer. Bone Marrow biopsy and clinical profile were correlated in M band positive cases.

Result: Out of 150 cases 10.66% cases had monoclonal gammopathy. Ten percent cases were diagnosed to be multiple myeloma and one case was found to be Monoclonal gammopathy of undetermined significance.

Conclusion: SPEP is an easy to perform laboratory test which can be used for detection and quantification of monoclonal gammopathy and should be recommended as preliminary test for suspected cases of multiple myeloma. MGUS must be differentiated from M.M, as management and prognosis of these two cases is totally different.

Keywords: Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Serum Protein Electrophoresis.

[Table/Fig-2]

SPEP Strip and Graph showing M spike in gamma region in Monoclonal gammopathy cases

[Table/Fig-3]

Normal pattern SPEP in our study

[Table/Fig-4]

Pie chart-showing percentage of different SPEP pattern