Korean J Hematol.  2007 Sep;42(3):276-282. 10.5045/kjh.2007.42.3.276.

Monoclonal Proteinuria as a Prognostic Factor for Multiple Myeloma Patients with Intact Immunoglobulin Type

• Koo DH
• Oh JS
• Choi SH
• Park HG
• Lee SS
• Kim MK
• Sym SJ
• Min WK
• Kim S
• Suh S

• KMID: 2305203
• DOI: http://doi.org/10.5045/kjh.2007.42.3.276

Abstract

BACKGROUND: Urine/serum protein electrophoresis (PEP) and immunofixation electrophoresis (IEP) for monoclonal protein (M-protein) are used for initial evaluation in patients with multiple myeloma. We evaluated the prognostic significance of M-proteinuria status and its association with other prognostic factors.
METHODS
Between December 2002 and December 2004, 64 de novo symptomatic multiple myeloma patients with intact immunoglobulin (Ig) type were divided into two groups according to their initial urine PEP/IEP findings.
RESULTS
Twenty-seven patients with undetectable or free light-chains only were classified into F group, and 37 with whole Ig with or without light-chains were classified into W group. The two groups were similar in sex, age, performance, azotemia, beta2-microglobulin, stage and treatment, but M-protein concentration was significantly higher in the W than in F group (5.1 vs 1.3g/dL, P<0.01). The overall response rate was significantly higher in F group than in W group (80.8% vs 63.6%, P=0.02), whereas the 2-year OS rate did not differ significantly between the groups (81.0% vs 57.7%, P=0.15).
CONCLUSION
Monoclonal proteinuria is helpful in identifying patients with advanced disease and poorer prognosis in multiple myeloma.

Keyword

Multiple myeloma; Proteinuria; Prognosis

MeSH Terms

Azotemia
Electrophoresis
Humans
Immunoglobulins*
Multiple Myeloma*
Prognosis
Proteinuria*
Immunoglobulins

Figure

• 

  Fig. 1 Overall survival curves relative to M-proteinuria.

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