我的患者血清单克隆峰是多发性骨髓瘤吗？
Does my patient with a serum monoclonal spike have multiple myeloma?
机构信息
Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Hematol Oncol Clin North Am. 2012 Apr;26(2):383-93, ix. doi: 10.1016/j.hoc.2012.02.009.
Abstract
A monoclonal spike on serum protein electrophoresis is a frequent finding in the general population and pathognomonic of a plasma cell dyscrasia. In otherwise healthy individuals, it is diagnostic of two asymptomatic, premalignant conditions called monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) which carry a lifelong risk of progression to multiple myeloma (MM) or related malignancy. This article discusses the criteria for diagnosis of MGUS, SMM, and MM; current recommendations for follow-up and risk factors for progression to MM of patients with MGUS and SMM; and diagnostic evaluation of suspected MM transformation.
摘要
血清蛋白电泳上单克隆 spike 是常见于普通人群中的发现，也是浆细胞异常的特征。在其他健康个体中，它是两种无症状、前恶性疾病的诊断指标，分别称为意义未明的单克隆丙种球蛋白血症（MGUS）和冒烟型多发性骨髓瘤（SMM），这两种疾病终生有进展为多发性骨髓瘤（MM）或相关恶性肿瘤的风险。本文讨论了 MGUS、SMM 和 MM 的诊断标准；MGUS 和 SMM 患者进展为 MM 的随访和风险因素的当前建议；以及疑似 MM 转化的诊断评估。
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