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CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(01): 162-165
DOI: 10.1055/s-0042-1750080
Case Report

Posttreatment Persistence of Monoclonal Protein on Immunofixation Electrophoresis but Absence on Serum Protein Electrophoresis in a Case of Solitary Bone Plasmacytoma

Visesh Kumar
1   Department of Biochemistry, All India Institute of Medical Sciences, Patna, Bihar, India
,
Priti Rani
1   Department of Biochemistry, All India Institute of Medical Sciences, Patna, Bihar, India
,
Neha Rai
1   Department of Biochemistry, All India Institute of Medical Sciences, Patna, Bihar, India
,
Subhash Kumar
2   Department of Radiodiagnosis, All India Institute of Medical Sciences , Patna, Bihar, India
,
Mala Mahto 
1   Department of Biochemistry, All India Institute of Medical Sciences, Patna, Bihar, India
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Abstract

Laboratory investigations for any suspected case of solitary plasmacytoma of bone include routine biochemical and hematological investigations along with β2-microglobulin, electrophoresis of serum protein and/or 24-hour urine protein, serum protein immunofixation (IFE), and nephelometric quantification of total immunoglobulin isotype and serum free light chain levels. Bone marrow aspirate and trephine biopsy are mandatory to confirm the absence of clonal plasma cells (for solitary plasmacytoma) or the presence of less than 10% clonal cells (solitary plasmacytoma with minimal bone marrow involvement). Imaging studies such as X-ray, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT should be used to complement laboratory tests in diagnosis, staging, and defining the local extent of the plasmacytoma. However, guidelines regarding choice of technique for the detection of M band when monitoring a follow-up case of operated plasmacytoma are still not clear. Through this case study, we try to highlight the role of IFE in a follow-up case of operated solitary plasmacytoma of the bone.

Keywords

plasmacytoma - serum protein electrophoresis - serum immunofixation


Publication History

Article published online:
26 July 2022

© 2022. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kilciksiz S, Karakoyun-Celik O, Agaoglu FY, Haydaroglu A. A review for solitary plasmacytoma of bone and extramedullary plasmacytoma. ScientificWorldJournal 2012; 2012: 895765
    CrossrefPubMedGoogle Scholar
  • 2 Durie BGM, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer 1975; 36 (03) 842-854
    CrossrefPubMedGoogle Scholar
  • 3 Durie BGM, Kyle RA, Belch A. et al; Scientific Advisors of the International Myeloma Foundation. Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Hematol J 2003; 4 (06) 379-398
    CrossrefPubMedGoogle Scholar
  • 4 Liebross RH, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R. Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy. Int J Radiat Oncol Biol Phys 1998; 41 (05) 1063-1067
    CrossrefPubMedGoogle Scholar
  • 5 Galieni P, Cavo M, Pulsoni A. et al. Clinical outcome of extramedullary plasmacytoma. Haematologica 2000; 85 (01) 47-51
    PubMedGoogle Scholar
  • 6 Soutar R, Lucraft H, Jackson G. et al; Guidelines Working Group of the UK Myeloma Forum, British Committee for Standards in Haematology, British Society for Haematology. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Br J Haematol 2004; 124 (06) 717-726
    CrossrefPubMedGoogle Scholar
  • 7 Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R. Solitary plasmacytoma of bone and asymptomatic multiple myeloma. Blood 2000; 96 (06) 2037-2044
    CrossrefPubMedGoogle Scholar
  • 8 International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003; 121 (05) 749-757
    CrossrefPubMedGoogle Scholar
  • 9 Rajkumar SV, Dimopoulos MA, Palumbo A. et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014; 15 (12) e538-e548
    CrossrefPubMedGoogle Scholar
  • 10 Caers J, Paiva B, Zamagni E. et al. Diagnosis, treatment, and response assessment in solitary plasmacytoma: updated recommendations from a European Expert Panel. J Hematol Oncol 2018; 11 (01) 10
    CrossrefPubMedGoogle Scholar
  • 11 Agbuduwe C, Yang H, Gaglani J, Ajithkumar T. Clinical presentation and outcomes of solitary plasmacytoma in a tertiary hospital in the UK. Clin Med (Lond) 2020; 20 (05) e191-e195
    CrossrefPubMedGoogle Scholar
  • 12 Wilder RB, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R. Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone. Cancer 2002; 94 (05) 1532-1537
    CrossrefPubMedGoogle Scholar
  • 13 Dingli D, Kyle RA, Rajkumar SV. et al. Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood 2006; 108 (06) 1979-1983
    CrossrefPubMedGoogle Scholar
  • 14 Chang WI, Koh HK, Yoon SS, Kim HS, Eom KY, Kim IH. The predictive value of serum myeloma protein in solitary plasmacytoma. Radiat Oncol J 2020; 38 (02) 129-137
    CrossrefPubMedGoogle Scholar
  • 15 Jean J, Vergara-Lluri M, Chambliss AB. No monoclonal protein in a patient with CRAB features. Clin Chem 2021; 67 (12) 1584-1588
    CrossrefPubMedGoogle Scholar