DEVELOPMENT OF A MYELOMA RISK SCORE USING A POPULATION-BASED REGISTRYON PARAPROTEINEMIA AND MYELOMA

Diagnostic systems for monoclonal gammopathies use bone marrow and X-r ay examinations to exclude multiple myeloma (MM), Data from a populati on-based registry of unselected patients with paraproteinemia indicate that these tests are often done only when MM is suspected. We used 44 1 randomly selected patients to develop a simple four point ''Myeloma Risk Score'' based on two readily available laboratory tests, One poin t was given for paraprotein concentration greater than or equal to 10 g/l, one point for IgG and IgA, and two points for IgD and light chain s only. A score of 0 or 1 indicated a low risk for MM, with scores of 2 and 3 signifying high risks. Sensitivity, specificity, positive and negative predictive value (PV) for the Myeloma Risk Score in the train ing sample were 92%, 88%, 79%, and 96% respectively. Extrapolating the se results to a larger cohort showed that 90% of patients with a monoc lonal gammopathy could be classified correctly as having MM or a non-m yeloma condition, The Myeloma Risk Score can identify patients with a paraproteinemia at risk for MM, and who are therefore candidates for b one marrow and X-ray examination.