Distribution of serum creatinine, calcium and protein levels in multiple myeloma patients - a hospital based study at Gauhati Medical College and Hospital, Guwahati, Assam
Abstract
Introduction: Multiple Myeloma (MM) is a clonal plasma cell neoplasm characterized by the proliferation of plasma cells, monoclonal protein, Osteolytic bone lesions, renal disease and immunodeficiency. It accounts for 15% of lymphatohematopoietic cancers (LHC) and 2% of all cancers in the US.
Objectives: To see distribution of serum creatinine, calcium and protein level among MM cases.
Methods: A hospital based cross-sectional descriptive study was conducted in the OPD of the clinical Haematology Department of Gauhati Medical College & Hospital, Guwahati, Assam during November, 2010 to October, 2013 with a study population of 100 in number of newly diagnosed MM) cases.
Results: Serum creatinine - 54 (54%) patients had < 1.2 mg/dl, 26 (26%) patients had1.3-1.9 mg/dland20 (20%) patients had > 2 gm/dl.Serum calcium -> 11 mg/dlin 36 (36%);< 8 mg/dl in(8%) ;8 -11 mg/dl in 56 (56%) patients. Serum total protein – higher level in 52 (52%) patients. Serum albumin -< 3.5 gm/dlin 26 (26%) patients, > 3.5 gm/dlin4 (4%) patients , Normal value in70 (70%) patients. Serum globulin - < 3.5 gm/dl in 28 (28%) patients,> 3.5 gm/dl in72 (72%) patients.
Conclusion: The most frequently detected SC was < 1.2 mg/ dl (84% patients),serum calcium 8-11 mg/dl (56% patients); serum total protein, albumin and globulin level were> 6.3-8.2gm/dl (52%), > 3-5 gm/dl (70%) and > 3.5 gm/dl (72 % patients) respectively.
Downloads
References
2. Terpos E, Dimopoulos MA. Myeloma bone disease: pathophysiology and management. Ann Oncol. 2005 Aug;16(8):1223-31. Epub 2005 May 31.
3. Kobayashi T, Kronenberg H. Minireview: transcriptionalregulation in development of bone. Endocrinology.2005 Mar;146(3):1012-7. Epub 2004 Dec 16.
4. Yukiko S, Hiroo Kato, William J. S. Studies of the Mortality of A-Bomb Survivors: 9. Mortality, 1950-1985: Part 2. Cancer Mortality Based on the Recently Revised Doses (DS86). Radiation Research;1990, Feb;121 (2): 120-141
5. Hayakawa N., Ohtaki M., Ueoka H. Et al. Mortality statistics of major causes of death among atomic bomb survivors in Hiroshima Prefecture from 1968-1982. Hiroshima J Med Sci. 1989; 38: 53-67.
6. Cogliano VJ, Baan R, Straif K, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Wild CP. Preventableexposuresassociated with humancancers. J Natl Cancer Inst.2011Dec 21;103(24):1827-39. doi: 10.1093/jnci/djr483. Epub2011Dec 12.
7. BoiceJDJr, Morin MM, Glass AG, Friedman GD, Stovall M, Hoover RN, Fraumeni JF Jr. Diagnostic x-rayprocedures and risk ofleukemia, lymphoma, and multiple myeloma. JAMA.1991Mar13;265(10):1290-4.
8. van Kaick G, Dalheimer A, Hornik S, Kaul A, Liebermann D, Lührs H, Spiethoff A, Wegener K, Wesch H. The germanthorotrast study: recent results and assessment of risks. Radiat Res. 1999 Dec;152(6 Suppl):S64-71. [PubMed]
9. Stebbings JH, Lucas HF, Stehney AF. Mortality from cancers of majorsites in femaleradiumdialworkers. Am JInd Med. 1984;5(6):435-59.
10. Lynch HT, Ferrara K, Barlogie B, Coleman EA, Lynch JF, Weisenburger D, Sanger W, Watson P, Nipper H, Witt V, Thomé S. Familial myeloma. N Engl J Med. 2008 Jul 10;359(2):152-7. doi: 10.1056/NEJMoa0708704.
11. Reeder CB, Reece DE, Kukreti V, Chen C, Trudel S, Hentz J, Noble B, Pirooz NA, Spong JE, Piza JG, Zepeda VH, Mikhael JR, Leis JF, Bergsagel PL, Fonseca R, Stewart AK. Cyclophosphamide, bortezomib and dexamethasoneinduction for newlydiagnosedmultiple myeloma: highresponseratesin aphase II clinical trial. Leukemia.2009 Jul;23(7):1337-41. doi: 10.1038/leu.2009.26. Epub2009 Feb 19. [PubMed]
12. Popat R, Oakervee HE, Hallam S, Curry N, Odeh L, Foot N, Esseltine DL, Drake M, Morris C, Cavenagh JD. Bortezomib, doxorubicin and dexamethasone (PAD) front-linetreatment of multiple myeloma: updatedresultsafterlong-termfollow-up.Br J Haematol.2008 May;141(4):512-6. doi: 10.1111/j.1365-2141.2008.06997.x.Epub2008 Mar 26.
13. Richardson PG, Weller E, Lonial S, Jakubowiak AJ, Jagannath S, Raje NS, Avigan DE, Xie W, Ghobrial IM, Schlossman RL, Mazumder A, Munshi NC, Vesole DH, Joyce R, Kaufman JL, Doss D, Warren DL, Lunde LE, Kaster S, Delaney C, Hideshima T, Mitsiades CS, Knight R, Esseltine DL, Anderson KC. Lenalidomide, bortezomib, and dexamethasonecombination therapy in patients with newlydiagnosedmultiple myeloma. Blood.2010 Aug 5;116(5):679-86. doi: 10.1182/blood-2010-02-268862. Epub2010 Apr 12.
14. Kaufman JL, Nooka A, Vrana M, Gleason C, Heffner LT, Lonial S. Bortezomib, thalidomide, and dexamethasone as induction therapy for patients with symptomaticmultiple myeloma: a retrospective study. Cancer.2010Jul 1;116(13):3143-51. doi: 10.1002/cncr.25143.
15. Zonder JA, Crowley J, Hussein MA, Bolejack V, Moore DF Sr, Whittenberger BF, Abidi MH, Durie BG, Barlogie B. Lenalidomide and high-dosedexamethasonecompared with dexamethasone as initialtherapy for multiple myeloma: a randomizedSouthwest Oncology Grouptrial (S0232). Blood.2010Dec 23;116(26):5838-41. doi: 10.1182/blood-2010-08-303487. Epub2010 Sep 27.
16. Gupta P, Kochupillai V et al. A 12 tears study of multiple myeloma at AIIMS, Ind J Med & Ped Oncol. 1995; Vol 16:108-114.
17. Kyle RA, Gertz MA, WitzigTE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Review of 1027patients with newlydiagnosedmultiple myeloma. Mayo Clin Proc.2003 Jan;78(1):21-33. [PubMed]
18. Riccardi A, Gobbi PG, Ucci G, Bertoloni D, Luoni R, Rutigliano L, Ascari E. Changingclinicalpresentation of multiple myeloma. Eur J Cancer.1991;27(11):1401-5.
19. Kyle RA. Multiple myeloma: review of 869 cases. Mayo Clin Proc. 1975 Jan;50(1):29-40. [PubMed]
20. Knudsen LM, Hippe E, Hjorth M, Holmberg E, Westin J. Renal function in newly diagnosed multiple myeloma--a demographic study of 1353 patients. The Nordic Myeloma
Study Group. Eur J Haematol. 1994 Oct;53(4):207-12.
21. Greer JP, Rodgers GM, Foerster j, et al. Wintrobe’s Clinical Hematology. Chapter 97, 11th edition. Philadelphia, USA: Lippincott Williams & Wilkins; 2004. p. 2566–7
22. Blade J. and Kyle R.A. Monoclonal gammopathies of undetermined significance. In Myeloma:Biology and Management. Eds. J.S. Malpas, D.E. Bergsagel and R.A. Kyle. (1st ed.). Oxford University of Press Inc. New York, 1995, p.433-62.
23. Kyle RA, Gertz MA, WitzigTE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Review of 1027patients with newlydiagnosedmultiple myeloma. Mayo Clin Proc.2003 Jan;78(1):21-33.