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Serbia

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Serbia
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Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant plasma cell proliferative disorder found in approximately 3 % of the general population 70 years of age and older. The hallmark of MGUS is the presence of a monoclonal immunoglobulin in the serum, commonly referred to as a monoclonal (M) protein. By definition, patients with MGUS have concentration of serum M-protein concentration less than 30 g/L, bone marrow plasma cells less than 10 %, and no anemia, hypercalcemia, lytic bone lesions, or renal failure that would be indicative of a malignant plasma cell disorder. MGUS is associated with progression to multiple myeloma or related malignancy at a rate of 1 % per year. The objective of this work was based on results of several studies point out the necessity of quantitative determination of free light chains (FLC) in serum of patients with MGUS. Since the MGUS is asymptomatic disease and the diagnosis of MGUS is usually result of screening serum protein electrophoresis (SPEP), as the essential part of diagnostic procedure. It is currently available quantitative immunoturbidimetry and nephelometry assay for determining the concentration of FLC, which is more sensitive than now used qualitative immunofixation assay for clinical-laboratory diagnostics. It allows quantitation of free kappa (?) and lambda (?) chains (ie, light chains are not bound to intact immunoglobulin) secreted by plasma cells. The presence of a onoclonal FLC in MGUS may be a marker of clonal evolution in the neoplastic plasma cell since it likely indicates a loss of control over the proportion of heavy and light chains synthesized. The presence of an abnormal FLC ratio is a clinically and statistically significant predictor of progression in MGUS.

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