Abstract：
BACKGROUND: 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.
OBJECTIVE: 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.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
OBJECTIVE: 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.
METHODS: 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).
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：多发性骨髓瘤（MM）是一种血液恶性肿瘤，全球发病率不断上升。MM的诊断应在初级保健水平开始，以达到最佳的患者预后。然而,这可能会由于非特异性症状而延迟，如背痛和疲劳。
目的：本研究的目的是调查通常要求的血液检查是否可以提示初级保健中的MM并可能导致早期诊断。
方法：这项回顾性观察性研究对109例MM患者的临床和实验室数据进行了审核，包括活动性MM患者（N=53），阴燃MM(N=33),和游离轻链MM(N=23)。
结果：在研究的16种潜在生物标志物中，早期发现活动性MM和阴燃MM的最有希望的指标是球蛋白（CG）的增加。活动性MM患者的CG中位数（50g/L）比健康对照组（28g/L）高78.6％。阴燃MM患者的CG中位数（38g/L），比对照组高出35.7%。感兴趣的，对照组的CG结果中位数仅比游离轻链MM组高16.7%，提示CG在检测这种亚型时不会那么有效。
结论：CG来源于总蛋白和白蛋白数据，通常在常规肝功能谱中测量，因此没有额外的测试或成本要求。基于这些数据,CG具有作为临床生物标志物的潜力，可以在初级保健水平上支持MM的早期检测，并允许进行适当的针对性研究。
目的：本研究的目的是调查通常要求的血液检查是否可以提示初级保健中的MM并可能导致早期诊断。
方法：这项回顾性观察性研究对109例MM患者的临床和实验室数据进行了审核，包括活动性MM患者（N=53），阴燃MM(N=33),和游离轻链MM(N=23)。
结果：在研究的16种潜在生物标志物中，早期发现活动性MM和阴燃MM的最有希望的指标是球蛋白（CG）的增加。活动性MM患者的CG中位数（50g/L）比健康对照组（28g/L）高78.6％。阴燃MM患者的CG中位数（38g/L），比对照组高出35.7%。感兴趣的，对照组的CG结果中位数仅比游离轻链MM组高16.7%，提示CG在检测这种亚型时不会那么有效。
结论：CG来源于总蛋白和白蛋白数据，通常在常规肝功能谱中测量，因此没有额外的测试或成本要求。基于这些数据,CG具有作为临床生物标志物的潜力，可以在初级保健水平上支持MM的早期检测，并允许进行适当的针对性研究。
