The Possibility of Developing Screening Criteria for Patients Suspected Multiple Myeloma (MM) at Thammasat University Hospital
Nonglak Kanitsap MD*, Sirikwan Umpunthongsiri MD*
Affiliation : * Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Patients suspected with multiple myeloma (MM) are often delayed investigation and diagnosis because of
multiple factors. The objective of this study was to evaluate factors leading to diagnosis of MM would help in early diagnosis
and treatments.
Objective : To evaluate the effectiveness of factors used for myeloma screening and to find any factors that can predict the
diagnosis of multiple myeloma.
Material and Method: From Aug 2013 to Mar 2015, 300 patients were enrolled into this study. Every patient must have met
the criteria of: 1) age above 50 years, 2) at least one of laboratory criteria (Hb <10 g/dL, serum creatinine >2 mg/dL, serum
calcium >10 mg/dL), and 3) at least one skeletal criterion (bone pain, osteoporosis or history of fracture). Eligible patients’
sample were sent for serum protein electrophoresis (SPEP) to screen for MM.
Results : From 300 patients, there were 70 patients (23.3%) diagnosed with MM. Of the 3 criteria, all patients (n = 300,
100%) had age above 50 years as inclusion criteria, mean age was 73 years, 273 cases (91%) had Hb below 10 g/dL,
83 cases (27.66%) had serum creatinine >2 mg/dL and 97 cases (32.33%) had serum calcium >10 mg/dL. However, there
was no factor successfully predicted MM diagnosis.
Conclusion : Among many factors those are the common presentation of MM, there were no factor or combination of factors
that shown statistically significant to predict the diagnosis of multiple myeloma. However, we would suggest thinking of MM
in elderly patients who have bone pain or osteoporosis, hypercalcemia, and azothemia or renal failure.
Keywords : Multiple myeloma, MM, Screening criteria, Serum protein electrophoresis
