Abstract
In the present study, monoclonal gammapathy was identified in a total of 245 patients of plasma cell dyscrasias during period of 1987 to 2000. The monoclonal band was identified in serum by agar gel electrophoresis in all the cases and in urine in a few cases. Characterization of paraprotein (monoclonal immunoglobulin class and light chain type) was carried out by employing immunoelectrophoresis and/or immunofixation electrophoresis using heavy chain specific gamma, alpha, mu, delta and epsilon and light chain specific kappa (K), lambda (λ) antisera. Serum immunoglobulins Ig G, Ig A, and Ig M were estimated by immunoturbidometry. Serum urea, creatinine, uric acid, alkaline phosphatase, total proteins, albumin, calcium and phosphorus were estimated by using routine biochemical methods. Among the 245 cases, 73.1% monoclonal gammapathies were of secretory type and 7.3% were non-secretory. Monoclonal gammapathies were associated with 80.4% of multiple myeloma, 8.9% of solitary plasmacytoma, 4.1% of extra-medullary plasmacytoma, 3.3% of lymphoma and 2.9% of plasma cell leukemia. Classification of secretory monoclonal immunoglobulin revealed monoclonal immunoglobulin Ig G in 74%, Ig A 15% and Ig M in 2.9% cases.
Similar content being viewed by others
References
Aguzzi, F., Bergaml, M.R., Gasparro, C., Bellotti, V. and Merlini, G. (1992) Occurence of monoclonal components in general practice: Clinical implications. Eur. J. Haematol. 48, 192–195.
Salmon, S.E. and Cassady, J.R. (1993) Plasma cell neoplasms in cancer: Principles and practice of oncology. Eds. Devita, V.T. Jr., Hellman, S. and Rosenberg, S.A. J.B. Lippincott company, Philadelphia, USA p. 1984–2025.
Osterland, C.K. (1989) Monoclonal gammapathies-their identification and biological significance. Clinica Chim. Acta 180, 1–22.
Osserman, E.F. and Takatsuki, K (1963) Plasma cell myeloma: Gammaglobulin synthesis and structure. and Medicine. 42, 357–384.
Kyle, R.A. (1975) Multiple myeloma review of 869 cases. Mayo Clin. Proc. 50, 29–40.
Merlini, G.E., Waldenstrom, J. and Jayakar, S.D. (1980) A new improved clinical staging system for multiple myeloma based on analysis of 123 treated patients. Blood. 55, 1011–1019.
Osserman, E.F., Merlini, G. and Butler, P.V. (1989) Multiple Myeloma and related plasma cell dyscrasias. J. Amer. Med. Assoc. 4, 354–361.
Blattner, W.A. (1980) Epidemiology of multiple myeloma and related plasma cell disordrs: An analytic review, In: Preogress in Myeloma. Ed. Potter, M. Elsevier Science publishers, Amsterdam. p. 1–65.
Waldentstrom, J. (1965) Macroglobulinemia. Adv. Metab. Dis. 2, 115.
Kyle, R.A. (1995) Waldenstrom's macroglobulinemia. In: Myeloma-Biology and Management Eds. Malpas, J.S., Bergsagel, D.E., Kyle, R.A. Oxford University Press, Oxford, p. 543–564.
Bence Jones, H. (1847) Papers on chemical pathology; prefaced by the galstonian lecture read at the Royal college of physicians, Lecture-3, Lancet 2, 88–92.
Solomon, A., Waldmann, T.A. and Fahey, J.L. (1964) Metabolism of Bence Jones Proteins. J. Clin. Invest. 43, 103–117.
Knowling, M.A., Harwood, A. and Bergsagel, D.E. (1983) A comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J. Clin. Oncol. 1, 255–262.
Franklin, E. C. (1984) The heavy chain diseases. Harvey Lecture. 78, 1–22.
Kyle, R.A., Greipp, P.R. and Banks, P.M. (1981) The diverse picture of gamma heavy-chain disease: Report of seven cases and review of literature. Mayo Clin. Proc. 56, 439.
Fermand, J.P., Brovet, J.C., Danon, F. and Seligmann, M (1989) Gamma heavy chain disease, heterogeneity of the clinico-pathologic features. Report of 16 cases and review of the literature. Medicine (Baltimore). 68, 321–335.
Finkel, P.N., Kronenberg, K. and Pesce, A.J. (1973) Adult Fanconi syndrome, amyloidosis and marked kappa light chain proteinuria. Nephrrn. 10, 1–24.
Subbarao, K. and Jacobson, H.G. (1986) Amyloidosis & Plasma cell dyscrasias of the musculo skeletal system. Seminars in Roentgenology 21, 139–149.
Siegelman, S.S. (1981) Plasma cell dyscrasias. In syllabus, Metabolic and Endocrine disorders affecting the skeleton: The radiological Society of North America. Ed. Jacobson, H.G. 609, C2-609 C-8.
Gupta, R.M., Varma, B.P., Gupta, I.M. and Gupta, Y.N. (1974) Myeloma-A correlated clinico-pathologic and immunologic study. Ind. J. Orthopaed. 8(2), 142–148.
Sehgal, S., Datta, Usha., Gulati, D.R., Grover, A. and Gupta, B.D. (1980) Spectrum of Lymphoid malignancies with particular reference of plasma cell dyscrasias in Chandigarh, India. In: Pathogenesis of Leukemias and Lymphomas: Environmental influences, Eds. Magrath, I.T., O'Conor, G.T. and Ramot, B. Raven press, New York, p. 47–59.
Innes, J. and Newell, J. (1961) Myelomatosis. Lancet, 1, 239.
Martin, N.H. (1961) The incidence of Myelomatosis. Lancet, 1, 237.
Yacoub, G.S. and Dubaybo, B.A. (1999) Plasmacytoma and upper airway obstruction. Amer. J. Otolaryngol 20(4), 257–259.
Rai, B., Chopra, B.K. and Dang, H.S. (1971) Multiple Myeloma: Clinical and laboratory findings in 22 cases. J. Assoc. Physicians of India. 19, 563–566.
Bergsagel, D.E. (1982) Plasma cell neoplasms and acute leukemia. In: Clinics in Hematology Eds. Hoffbrand, A.V., Lasch, H.G., Nathan, D.G. Salmon, S.E. (guest ed.): Clin. Haematol, W.B. Saunders, Eastboume. 11, 221–234.
Bergsagel, D.E., Bailey, A.J. and Langley, G.R. (1979) The Chemotherapy of plasma cell myeloma and the incidence of acute leukemia. New Engl. J. Med. 301, 743.
Ko, H.S. and Pruzanski, W. (1976) M Components associated with lymphoma: a review of 62 cases. Amer. J. Med. Sci. 272, 175–183.
Jacobson, D.R. and Zolla-Pazner, S. (1986) Immunosupression and infection in multiple myeloma. Semin. Oncol. 13, 282–290.
Nemni, R., Gerosa, E., Piccolo, G. and Merlini, G. (1994) Neuropathies associated with monoclonal gammapathies. Hematologica 79, 557–566.
Kapadia, S.B. (1980) Multiple myeloma, A clinicopathological study of 62 consecutively autopsied cases. Medicine (Baltimore), 59, 380.
Martinez Maldonado, M., Gium, J., Suki, W.N., Eknoyan, G (1971) Renal complications in multiple myeloma, pathophysiology and some aspects of clinical management. J. Chronic. Dis. 24, 221–257
Thorner, P.S., Bedard, Y.C., Fernandes, B.J. (1983) Lambda light chain nephropathy with Fanconi's syndrome. Arch. Path. & Lab. Med. 107(12), 654–657.
Soloman, A., Weiss, D.T. and Kattine, A.A. (1991) Nephrotoxic potential of Bence Jones proteins. New Engl. J. Med., 324, 1845–1851.
Maldonado, J.E., Velosa, J.A. and Kyle, R.A. (1975) Fanconi syndrome in adults: A manifestation of a latent form of myeloma. Amer. J. Med. 58, 354–364.
Payne, R., Little, A. and Williams, R., Brit. Med. J. (1973) Interpretation of serum calcium in patients with abnormal serum proteins. Brit. Med. J., 4, 643.
Kyle, R.A. (1999) Maintenance therapy and supportive care for patients with multiple myeloma. Semin. Oncol. 26, (5 suppl 13), 35–42.
McCloskey, E.V., Galloway, J., Morgan, M.A. and Kanis, J.A. (1989) Pseudohyperphosphataemia multiple myeloma. Brit. Med. J. 299, 1381–1382.
McCloskey, E.V., Yates, A.J.P., Gray, R.E.S., Hamdy, N.A.T., Galloway, J. and Kanis, J.A. (1988) Diphosphonates and phosphate homeostasis in man. Clin. Sci. 74, 607–612.
Hart, J.S., Lawrence, M.C., Ritzmann, S.E. and Levin, W.C. (1965) II Hyper and hypoproteinemias 1. Hyperproteinemia. Correlation of elevated total serum protein values and their responsible globulin fractions with various polyclonal and monoclonal gammapathies. A study of 173 sera. Tex. Rep. Biol. Med. 23, 445–457.
Cox, E.B. (1980) Prognosis in myeloma: key role of uric acid in azotemia. Proc. AACR-ASCO 21, 483.
Durie, B.G.M., Salmon, S.E. and Moon, T.E. (1980) Pretreatment tumor mass, cell kinetics and prognosis in multiple myeloma. Blood 55, 364–372.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Malati, T., Yadagiri, B., Krishna, D.M.M. et al. Spectrum of monoclonal gammapathies in Andhra Pradesh. Indian J Clin Biochem 16, 52–59 (2001). https://doi.org/10.1007/BF02867568
Issue Date:
DOI: https://doi.org/10.1007/BF02867568