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2nd round audit of skeletal surveys in patients with Monoclonal Gammopathy of Undetermined Significance (MGUS)
Poster Title: 2nd round audit of skeletal surveys in patients with Monoclonal Gammopathy of Undetermined Significance (MGUS)
Submitted on 29 Aug 2014
Author(s): Dr Ganesh Retnasingam, Dr Laura Day and Dr Yvette Griffin
Affiliations: Leicester Royal Infirmary, University Hospitals of Leicester (UHL)
Poster Views: 1,298
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Poster Information
Abstract: Purpose:
To ensure British Journal of Haematology guidelines are being followed by the haematologists at University Hospitals of Leicester and no unnecessary requests for skeletal surveys in MGUS as per agreed action plan following results from 1st round audit.
Results of 1st round audit from 16/10/2006 to 16/12/2011 showed 14% of 88 MGUS patients had a skeletal survey when not indicated. This is because they had a paraprotein <10g/l and no other risk factors.
We retrospectively reviewed consecutive patients from the myeloma MDT database, newly diagnosed with MGUS, between May 2013 to May 2014.
From ilab we obtained paraprotein type/level, serum kappa/lambda ratio, renal function, full blood count, B2 microglobulin, serum calcium, albumin, urine Bence-Jones Protein. If any of these were abnormal they were considered risk factors for progression to myeloma.
24 patients: 8 male, 16 female. Average age 72, age range 49 to 92. Only 1 patient had skeletal survey when not indicated with a serum paraprotein level of 2.2g/l and no risk factors.
Summary: Action plan post 1st round audit has been successfully implemented. 100% requests for Urine Bence Jones protein and serum kappa/lambda ratio (previously 79 out of 88 (90%) and 33 out of 88 (38%) respectively requested). Only 1 out of 24 patients had an inappropriate referral for skeletal surveys with MGUS. References: UK Myeloma Forum (UKMF) and Nordic Myeloma Study Group(NMSG): guidelines for the investigation of newly detected M-proteins and the management of monoclonal gammopathy of undetermined significance (MGUS); Jenny Bird,Judith Behrens,Jan Westin et al; British Journal of Haematology; 147, 22–42, 2009.
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