Calculated Globulin as a potential screening tool for paraproteinemia to aid in the early diagnosis of Multiple Myeloma.

Aisling O'Brien, Alison Bransfield, Fiona O'Halloran, Vitaliy Mykytiv

Clinical biochemistry 2023 Jun

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Multiple Myeloma (MM) is a haematological malignancy with increasing global incidence. Diagnosis of MM should be initiated at the primary care level to achieve the best patient outcome. However, this can be delayed due to nonspecific presenting symptoms, such as back pain and fatigue. The aim of this study was to investigate if commonly requested blood tests could indicate MM in primary care and potentially lead to earlier diagnosis. This retrospective observational study involved an audit of clinical and laboratory data from 109 MM patients, including patients with Active MM (N = 53), Smouldering MM (N = 33), and Free light chain MM (N = 23). Of the 16 potential biomarkers investigated, the most promising indicator for early detection of active MM and Smouldering MM was an increased Calculated Globulin (CG). The median CG for patients with active MM (50 g/L) was 78.6% higher than the healthy control group (28 g/L). Smouldering MM patients had a median CG value (38 g/L), which was 35.7% higher than the control group. Of interest, the median CG result was only 16.7% higher in the control group than in the free light chain MM group, suggesting CG would not be as effective at detecting this subtype. CG is derived from Total Protein and Albumin data, which are commonly measured in routine liver function profiles, thus there is no additional test or cost requirement. Based on these data, CG has potential as a clinical biomarker to support early detection of MM at the primary care level and allow for appropriate targeted investigations. Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Citation

Aisling O'Brien, Alison Bransfield, Fiona O'Halloran, Vitaliy Mykytiv. Calculated Globulin as a potential screening tool for paraproteinemia to aid in the early diagnosis of Multiple Myeloma. Clinical biochemistry. 2023 Jun;116:113-119