Detection and typing of paraproteins: Comparison of different methods in a routine diagnostic laboratory

Guinan, J C; Kenny, D.; Gatenby, Paul A.

doi:10.3109/00313028909059528

Cited by 12 publications

(5 citation statements)

References 21 publications

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“…For many years, sIFE has been the gold standard to confirm and characterize the initial detection of an M protein, and, as such, it is used as a comparator for other methods. [44][45][46] Early comparison studies reported a similar sensitivity of ISUB and sIFE for detecting MFLC or small intact M proteins 47,48 (,0.3 g/dL). However, later Jolliff et al 49 reported complete agreement between sIFE and ISUB on 240 cases with M proteins as low as 0.22 g/dL.…”

Section: Guideline Statementsmentioning

confidence: 99%

“…The EP discussed the use of alternative assays that have demonstrated similar sensitivities when compared with sIFE. [44][45][46][47][48][49][50] Again, studies comparing the sensitivity and specificity of sIFE versus other assays, such as ISUB and mass spectrophotometry, were published prior to our inclusion dates. The MASS-FIX technique is relatively new and has shown to have comparable or better sensitivity than sIFE or sFLC.…”

Section: Guideline Statementsmentioning

confidence: 99%

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Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Keren

Bocsi

Billman

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— The process for identifying patients with monoclonal gammopathies is complex. Initial detection of a monoclonal immunoglobulin protein (M protein) in the serum or urine often requires compilation of analytical data from several areas of the laboratory. The detection of M proteins depends on adequacy of the sample provided, available clinical information, and the laboratory tests used. Objective.— To develop an evidence-based guideline for the initial laboratory detection of M proteins. Design.— To develop evidence-based recommendations, the College of American Pathologists convened a panel of experts in the diagnosis and treatment of monoclonal gammopathies and the laboratory procedures used for the initial detection of M proteins. The panel conducted a systematic literature review to address key questions. Using the Grading of Recommendations Assessment, Development, and Evaluation approach, recommendations were created based on the available evidence, strength of that evidence, and key judgements as defined in the Grading of Recommendations Assessment, Development, and Evaluation Evidence to Decision framework. Results.— Nine guideline statements were established to optimize sample selection and testing for the initial detection and quantitative measurement of M proteins used to diagnose monoclonal gammopathies. Conclusions.— This guideline was constructed to harmonize and strengthen the initial detection of an M protein in patients displaying symptoms or laboratory features of a monoclonal gammopathy. It endorses more comprehensive initial testing when there is suspicion of amyloid light chain amyloidosis or neuropathies, such as POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome, associated with an M protein.

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Section: Guideline Statementsmentioning

confidence: 99%

Section: Guideline Statementsmentioning

confidence: 99%

Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Keren

Bocsi

Billman

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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“…The data collected from the scattering of light can be used with computer software to create an electropherogram, which visually represents the various densities as peaks [ 1 ]. Although nephelometry can also be used to quantify immunoglobulins, this assay is not specific for paraproteins and will quantify both the clonal and polyclonal immunoglobulin as a whole [ 49 ].…”

Section: Overview Of Laboratory Techniques Used To Diagnose Igm Pamentioning

confidence: 99%

“…MALT: mucosa-associated lymphoid tissue. References: [ 23 , 24 , 32 , 38 , 40 , 45 , 48 , 49 , 50 ].…”

Section: Figurementioning

confidence: 99%

Immunoglobulin M Paraproteinaemias

Girard

Soekojo

Ooi

et al. 2020

Cancers

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Monoclonal paraproteinaemia is an increasingly common reason for referral to haematology services. Paraproteinaemias may be associated with life-threatening haematologic malignancies but can also be an incidental finding requiring only observation. Immunoglobulin M (IgM) paraproteinaemias comprise 15–20% of monoclonal proteins but pose unique clinical challenges. IgM paraproteins are more commonly associated with lymphoplasmacytic lymphoma than multiple myeloma and can occur in a variety of other mature B-cell neoplasms. The large molecular weight of the IgM multimer leads to a spectrum of clinical manifestations more commonly seen with IgM paraproteins than others. The differential diagnosis of B-cell and plasma cell dyscrasias associated with IgM gammopathies can be challenging. Although the discovery of MYD88 L265P and other mutations has shed light on the molecular biology of IgM paraproteinaemias, clinical and histopathologic findings still play a vital role in the diagnostic process. IgM secreting clones are also associated with a number of “monoclonal gammopathy of clinical significance” entities. These disorders pose a novel challenge from both a diagnostic and therapeutic perspective. In this review we provide a clinical overview of IgM paraproteinaemias while discussing the key advances which may affect how we manage these patients in the future.

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“…IFE avoids some of the limitations of IEP for identification of IgM (12). Moreover, IFE is more sensitive than IEP (13) for the detection of small monoclonal bands, but the clinical and biological significance of these small bands is unclear (12). Spontaneous disappearance of a measurable M-protein is a rare event (14).…”

Section: Diagnostic and Clinical Aspectsmentioning

confidence: 99%

Prevalence, clinical aspects, and natural history of IgM MGUS

McMaster

Landgren

2010

Cytometry Part B Clinical

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Results: There appears to be marked heterogeneity in the prevalence of IgM MGUS across populations. However, studies have varied in definition, design, laboratory methods, and endpoints. IgM MGUS differs from non-IgM MGUS in certain respects, including prevalence across racial groups, rate of progression, and pattern of malignant outcomes. There are limited data regarding the coincident occurrence of IgM MGUS and MBL.Conclusions: Future studies incorporating both protein electrophoresis and flow cytometry are needed to define the underlying spectrum and causes of precursor development, risk factors for progression, and markers that distinguish low-and high-risk precursor patients. Published

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Detection and typing of paraproteins: Comparison of different methods in a routine diagnostic laboratory

Cited by 12 publications

References 21 publications

Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Immunoglobulin M Paraproteinaemias

Prevalence, clinical aspects, and natural history of IgM MGUS

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