[Algorithm management for detection of monoclonal gammopathies in serum. Experience of the Instituto Nacional de Cancerología in México].

BACKGROUND

Most patients with multiple myeloma have an abnormal band in the gamma region of protein electrophoresis.

AIM

To correlate the clinical diagnosis with patterns of protein electrophoresis.

METHODS

Retrospective analysis of all protein electrophoresis or immunoglobulin quantification requested during 1992 and review of clinical charts of patients.

RESULTS

During 1992, 553 protein electrophoresis were requested. Of these, 344 were repetitions and 209 came from patients seen for the first time. Among the latter, we found a monoclonal component in 40. Of these 40 patients, 35 had a multiple myeloma, one had a plasmocytoma and four a non-Hodgkin lymphoma. Fourteen patients with diagnosis of myeloma did not have a monoclonal component in protein electrophoresis. These figures resulted in a 71% sensitivity and 97% specificity for monoclonal components in the diagnosis of multiple myeloma. The monoclonal component of patients with myeloma was characterized as IgG in 29 (60%), IgA in 5 (10%) and IgM in one.

CONCLUSIONS

A monoclonal component present in a protein electrophoresis has a high diagnostic accuracy for multiple myeloma.