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. 2020 Oct 22;21(1):215.
doi: 10.1186/s12875-020-01283-x.

Development of a clinical diagnostic tool to differentiate multiple myeloma from bone metastasis in patients with destructive bone lesions (MM-BM DDx)

Phichayut Phinyo  1   2   3 , Titinat Maihom  3 , Areerak Phanphaisarn  3 , Pakorn Kerdsinchai  3 , Ekarat Rattarittamrong  4 , Jayanton Patumanond  2 , Dumnoensun Pruksakorn  5   6   7   8
Affiliations

Development of a clinical diagnostic tool to differentiate multiple myeloma from bone metastasis in patients with destructive bone lesions (MM-BM DDx)

Phichayut Phinyo et al. BMC Fam Pract. .

Erratum in

Abstract

Background: Most patients with destructive bone lesions undergo a comprehensive diagnostic procedure to ensure that proper treatment decisions are pursued. For patients with multiple myeloma, this can lead to delays in diagnosis and treatment initiation. This study was conducted to develop a diagnostic rule that could serve as a tool for early identification of multiple myeloma and promote timely referral of patients to haematologists.

Methods: The clinical prediction rule was developed using a retrospective case-series of patients with multiple myeloma (MM) and those with bone metastasis (BM) at Chiang Mai University Hospital from 2012 to 2015. Multivariable fractional polynomial logistic regression was used to derive a diagnostic model to differentiate between MM and BM patients (MM-BM DDx).

Results: A total of 586 patients (136 MM patients and 450 BM patients) were included. Serum creatinine, serum globulin, and serum alkaline phosphatase were identified as significant indicators for the differentiation of MM and BM patients. The MM-BM DDx model showed excellent discriminative ability [AuROC of 0.90 (95%CI 0.86 to 0.93)] and good calibration.

Conclusions: This MM-BM DDx model could potentially allow for early myeloma diagnosis and improvement of overall prognosis. A prospective validation study is needed to confirm the accuracy of the MM-BM DDx model prior to its application in clinical practice.

Keywords: Bone metastasis; Diagnosis; Multiple myeloma; Osteolytic lesion; Prediction.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram of MM and BM case-series
Fig. 2
Fig. 2
a Receiver operating characteristics curve (ROC) of the diagnostic prediction model for multiple myeloma based on clinical laboratory values. AuROC 0.90 (95%CI 0.86–0.93) b Model calibration plot of the agreement between model predicted odds and observed proportion of patients with multiple myeloma for each decile of predicted odds
Fig. 3
Fig. 3
The web application interface of the MM-BM DDx model. Three clinical laboratory parameters can be used for prediction of the presence of multiple myeloma
See this image and copyright information in PMC

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