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Some problems in the laboratory findings in multiple myeloma
Nihon Ketsueki Gakkai Zasshi : Journal of Japan Haematological Society
|December 1, 1989
Summary
Elevated alkaline phosphatase (ALP) in multiple myeloma (MM) may indicate recent pathological fractures. Serum lactate dehydrogenase (LDH) levels and isoenzyme patterns can differentiate MM subtypes and tumor progression.
Area of Science:
- Biochemistry
- Oncology
- Hematology
Background:
- Multiple myeloma (MM) is a hematologic malignancy characterized by uncontrolled plasma cell proliferation.
- Understanding the clinical utility of serum alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) is crucial for MM management.
- Investigating the mechanisms behind hypoalbuminemia and hypocholesterolemia in MM provides insights into disease pathogenesis.
Purpose of the Study:
- To evaluate the clinical significance of serum ALP and LDH levels in patients with multiple myeloma.
- To explore the pathogenetic mechanisms underlying hypoalbuminemia and hypocholesterolemia in MM.
- To correlate biochemical markers with disease characteristics and clinical outcomes in MM.
Main Methods:
- Serum samples from MM patients were analyzed for ALP, LDH, total protein, albumin, and cholesterol levels.
- LDH isoenzyme patterns were assessed to differentiate tumor types.
- Clinical data, including history of pathological fractures and disease classification (Greipp), were correlated with biochemical findings.
Main Results:
- Elevated serum ALP levels were significantly associated with a history of pathological fractures in MM patients within the preceding two months.
- Approximately 80% of MM patients had normal serum LDH levels; these patients exhibited a normal isoenzyme pattern and mature cell types.
- MM patients with elevated serum LDH showed a tumor isoenzyme pattern and the plasmablastic subtype, suggesting correlation with more aggressive disease.
- Decreased serum cholesterol in MM patients correlated with total protein and serum cholinesterase, consistent with reduced hepatic albumin synthesis.
Conclusions:
- Elevated serum ALP can serve as a biomarker for recent pathological fractures in MM.
- Serum LDH levels and isoenzyme analysis are valuable in characterizing MM subtypes and assessing tumor burden.
- Hypocholesterolemia in MM is likely a consequence of decreased hepatic albumin synthesis, similar to other conditions like nephrotic syndrome.