The concentration and type of monoclonal protein and their impact on clinical severity in patients with symptomatic myeloma

Abstract

Background and objectives: Multiple Myeloma is a clonal plasma cell proliferation in the bone marrow that produces abnormal monoclonal proteins in serum and /or urine that leads to end-organ damage. We aimed to evaluate concentration, type of monoclonal protein, and their impact on the severity of symptomatic multiple myeloma patients. Methods: The study was conducted on 124 patients with symptomatic myeloma who were registered in the three centers in Kurdistan-Iraq from January–June 2019. Out of the 74 were males, and 50 were females. Demographic details, laboratory investigations, imaging study were reviewed, and informed consent was obtained for all patients; smoldering myeloma was excluded. Results: The most prevalent subtypes were IgG followed by IgA (61.3%, 18.5% respectively), whereas free light chain and non-secretory myeloma forming the rest, 12.1% and 6.45% for each subtype. There is a statistically positive association found between the concentration of monoclonal protein and the level of hemoglobin, ß2-microglobulin, and lactic acid dehydrogenase. There is no association for the concentration of monoclonal protein with each of calcium, albumin, creatinine, and erythrocyte sedimentation rate. Conclusions: We found a higher percentage of IgG/Kappa, high rates of non-secretory myeloma, low rates of light chain myeloma and younger age at presentation in comparison to western reports. The association between monoclonal protein concentration and some parameter of prognostic value in patients studied underscores its relevance to severity of disease in our locality.