Serum neural cell adhesion molecule differentiates multiple myeloma from
paraproteinemias due to other causes
F Ong, U Kaiser, PJ Seelen, J Hermans, PW Wijermans, W de Kieviet, G Jaques and JC Kluin-Nelemans
Comprehensive Cancer Center West, Leiden, The Netherlands.
Serum neural cell adhesion molecule (NCAM) has been described as a
prognostic marker in multiple myeloma (MM). Both C-reactive protein (CRP)
and beta 2-microglobulin (beta 2M) are established prognostic markers in
MM. We tested the diagnostic value of these markers in 212 serum samples of
patients with paraproteinemia registered prospectively in a
population-based registry. Sixty patients had MM and 152 had other
monoclonal gammopathies (hematologic diseases [48], paraneoplastic disease
[35], autoimmune disease [15], and monoclonal gammopathy of undetermined
significance [56]). CRP and beta 2M had wide and overlapping ranges in all
diagnostic categories. However, serum neural cell adhesion molecule (NCAM)
was low (< 20 U/mL) in all but 4 of 152 nonmyeloma cases and high (>
or = 20 U/mL) in 31 (52%) of the 60 MM cases. Two patients with
non-Hodgkin's lymphoma, 1 with chronic lymphatic leukemia, and 1 with
autoimmune disease had serum NCAM values between 20 and 30 U/mL. In a
discriminant analysis in which serum NCAM, CRP, beta 2M, paraprotein type
and concentration, hemoglobin, leukocyte and thrombocyte counts,
creatinine, corrected calcium, lactate dehydrogenase, and alkaline
phosphatase were included, paraprotein type and concentration and serum
NCAM turned out to be the best combination of parameters predicting whether
a patient had MM, with 89% of cases being correctly classified. Even
without bone marrow and x-ray examinations, serum NCAM, in combination with
paraprotein type and concentration, can differentiate between MM and
nonmyeloma patients.
Volume 87,
Issue 2,
pp. 712-716,
01/15/1996
Copyright © 1996 by The American Society of Hematology
