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. 2023 Feb 8;12(4):1345.
doi: 10.3390/jcm12041345.

A Stepwise Screening Protocol for Multiple Myeloma

Marta Morawska  1 , Jadwiga Dwilewicz-Trojaczek  2 , Tomasz Stompór  3 , Piotr Ligocki  4 , Marek Stopiński  5 , Michał Sutkowski  6 , Norbert Grząśko  1 , Anna Kordecka  7 , Mariusz Kordecki  7 , Artur Jurczyszyn  8 , Dominik Dytfeld  9 , Tomasz Wróbel  10 , Krzysztof Jamroziak  2 , Agnieszka Druzd-Sitek  11 , Adam Walter-Croneck  12 , Krzysztof Giannopoulos  1
Affiliations

A Stepwise Screening Protocol for Multiple Myeloma

Marta Morawska et al. J Clin Med. .

Abstract

Background: Monoclonal gammopathies and multiple myeloma should be screened in the primary care setting.

Methods: The screening strategy consisted of an initial interview supported with the analysis of basic laboratory test results and the increasing laboratory workload in the following steps was developed based on characteristics of patients with multiple myeloma.

Results: The developed 3-step screening protocol includes evaluation of myeloma-related bone disease, two renal function markers, and three hematologic markers. In the second step, the erythrocyte sedimentation rate (ESR) and the level of C-reactive protein (CRP) were cross-tabulated to identify persons qualifying for confirmation of the presence of monoclonal component. Patients with diagnosed monoclonal gammopathy should be referred to a specialized center to confirm the diagnosis. The screening protocol testing identified 900 patients with increased ESR and normal level of CRP and 94 of them (10.4%) had positive immunofixation.

Conclusions: The proposed screening strategy resulted in an efficient diagnosis of monoclonal gammopathy. The stepwise approach rationalized the diagnostic workload and cost of screening. The protocol would support primary care physicians, standardizing the knowledge about the clinical manifestation of multiple myeloma and the method of evaluation of symptoms and diagnostic test results.

Keywords: monoclonal gammopathy; multiple myeloma; screening.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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