Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan.
Medicine (Baltimore). 2024 Jun 7;103(23):e38523. doi: 10.1097/MD.0000000000038523.
Multiple myeloma (MM) was one of the hardest cancers to diagnose because of numerous nonspecific symptoms, leading to diagnostic delay. Proactive consultation of laboratory medicine (PCLM) could help timely diagnosis of blood cancers, avoiding diagnostic delay. This study aimed to evaluate the effect of PCLM on diagnosis and outcomes in MM. This retrospective study was conducted in newly diagnosed MM patients from 2011 to 2022. Implementation of PCLM initiated in 2015 with a laboratory-oriented algorithm. The annual diagnostic rate, patient demographics, the time intervals from symptom onset to diagnosis and to treatment, and clinical outcomes were analyzed. A total of 134 patients were newly diagnosed during the study interval. The diagnostic rate increased from 4.65 ± 1.59 to 7.43 ± 1.52 per million patient-visits after implementation of PCLM. The median time interval from symptom onset to diagnosis was significantly shortened after implementation of PCLM (50 days with interquartile range [IQR]: 24-136 days vs 150 days with IQR: 41-385 days, P = .003). Besides, the 1-year survival was significantly higher in patients diagnosed as MM after implementation of PCLM (72.4% vs 51.7%, P = .035). Implementation of PCLM not only increased diagnostic rate of MM and improved outcomes, but also raise awareness for MM and promote multidisciplinary collaboration in healthcare.
多发性骨髓瘤（MM）是最难诊断的癌症之一，因为其存在许多非特异性症状，导致诊断延迟。主动咨询检验科（PCLM）可以帮助及时诊断血液系统癌症，避免诊断延迟。本研究旨在评估 PCLM 对 MM 诊断和预后的影响。本回顾性研究纳入了 2011 年至 2022 年间新诊断的 MM 患者。2015 年开始实施以实验室为导向的算法的 PCLM。分析了每年的诊断率、患者特征、从症状出现到诊断和治疗的时间间隔以及临床结局。在研究期间，共 134 名患者新诊断为 MM。实施 PCLM 后，诊断率从每百万患者就诊 4.65±1.59 例增加到 7.43±1.52 例。实施 PCLM 后，从症状出现到诊断的中位时间间隔显著缩短（50 天，四分位距[IQR]：24-136 天与 150 天，IQR：41-385 天，P=0.003）。此外，实施 PCLM 后诊断为 MM 的患者 1 年生存率显著提高（72.4% vs. 51.7%，P=0.035）。实施 PCLM 不仅提高了 MM 的诊断率和改善了结局，还提高了对 MM 的认识并促进了医疗保健中的多学科合作。
