Paraproteins Identification Methods Compared for Monoclonal Gammopathies
By LabMedica International staff writers Posted on 18 Mar 2021 |
Image: The HYDRASYS 2 Electrophoresis Automated System (Photo courtesy of Sebia).
Monoclonal gammopathy, also known as paraproteinemia, is the presence of excessive amounts of myeloma protein or monoclonal gamma globulin in the blood. It is usually due to an underlying immunoproliferative disorder or hematologic neoplasms, especially multiple myeloma.
In monoclonal gammopathies, the full laboratory workup for initial diagnosis and disease relapse includes a complete blood count and differential, a peripheral blood smear, a chemistry screen including calcium and creatinine, serum protein electrophoresis, serum immunofixation (IFE), immunoturbidimetric or immunonephelometric quantification of serum Ig, routine urinalysis, 24-hour urine collection for electrophoresis and immunofixation, serum β2-microglobulin, lactate dehydrogenase, and measurement of serum free light chains.
Medical Laboratory Scientists at the MDI Limbach Berlin GmbH (Berlin, Germany) evaluated methodic differences between serum immunofixation and serum immunosubtraction as well as in the quantitation of serum immunoglobulins on different clinical chemical platforms. The scientists used 322 unique routine patient samples and used for comparison between serum immunofixation (IFE) on HYDRASIS 2 (Sebia, Lisses, France) and serum immunosubtraction (ISE) on Sebia's CAPILLARYS 2 as well as between quantitation results of immunoglobulin A, G, and M on the ARCHITECT c16000PLUS (Abbott Core Laboratory, Abbott Park, IL, USA) and the Cobas c 502 module (Roche Diagnostics, Rotkreuz, Switzerland). The median age of patients was 75 years.
The scientists reported that IFE detected and identified a total of 69 paraproteinemias, while ISE only detected monoclonal proteins in 51 samples, a difference of 26%. ISE failed to detect 6/7 samples with biclonal paraproteinemias as well as 8/11 monoclonal paraproteins involving IgA and 4/10 monoclonal paraproteins involving IgM identified by IFE. For monoclonal paraproteins involving IgG, the total number of detections was 39 in IFE and 38 in ISE. Samples with paraproteinemia were nearly evenly split between sexes. Paraprotein identification differed remarkably between immunofixation and immunosubtraction. Quantitation of serum immunoglobulins showed higher values on Abbott's ARCHITECT c16000PLUS when compared with Roche's Cobas c 502 module.
The authors concluded that identification of paraproteins via serum immunosubtraction is inferior to serum immunofixation, which can have implications on the diagnosis and monitoring of patients with monoclonal gammopathy. If immunoturbidimetric quantitation of immunoglobulins is used for follow-up, the same clinical-chemical platform should be used consistently. The study was published on February 26, 2021 in the journal Archives of Pathology and Laboratory Medicine.
Related Links:
MDI Limbach Berlin GmbH
Sebia
Abbott Core Laboratory
Roche Diagnostics
In monoclonal gammopathies, the full laboratory workup for initial diagnosis and disease relapse includes a complete blood count and differential, a peripheral blood smear, a chemistry screen including calcium and creatinine, serum protein electrophoresis, serum immunofixation (IFE), immunoturbidimetric or immunonephelometric quantification of serum Ig, routine urinalysis, 24-hour urine collection for electrophoresis and immunofixation, serum β2-microglobulin, lactate dehydrogenase, and measurement of serum free light chains.
Medical Laboratory Scientists at the MDI Limbach Berlin GmbH (Berlin, Germany) evaluated methodic differences between serum immunofixation and serum immunosubtraction as well as in the quantitation of serum immunoglobulins on different clinical chemical platforms. The scientists used 322 unique routine patient samples and used for comparison between serum immunofixation (IFE) on HYDRASIS 2 (Sebia, Lisses, France) and serum immunosubtraction (ISE) on Sebia's CAPILLARYS 2 as well as between quantitation results of immunoglobulin A, G, and M on the ARCHITECT c16000PLUS (Abbott Core Laboratory, Abbott Park, IL, USA) and the Cobas c 502 module (Roche Diagnostics, Rotkreuz, Switzerland). The median age of patients was 75 years.
The scientists reported that IFE detected and identified a total of 69 paraproteinemias, while ISE only detected monoclonal proteins in 51 samples, a difference of 26%. ISE failed to detect 6/7 samples with biclonal paraproteinemias as well as 8/11 monoclonal paraproteins involving IgA and 4/10 monoclonal paraproteins involving IgM identified by IFE. For monoclonal paraproteins involving IgG, the total number of detections was 39 in IFE and 38 in ISE. Samples with paraproteinemia were nearly evenly split between sexes. Paraprotein identification differed remarkably between immunofixation and immunosubtraction. Quantitation of serum immunoglobulins showed higher values on Abbott's ARCHITECT c16000PLUS when compared with Roche's Cobas c 502 module.
The authors concluded that identification of paraproteins via serum immunosubtraction is inferior to serum immunofixation, which can have implications on the diagnosis and monitoring of patients with monoclonal gammopathy. If immunoturbidimetric quantitation of immunoglobulins is used for follow-up, the same clinical-chemical platform should be used consistently. The study was published on February 26, 2021 in the journal Archives of Pathology and Laboratory Medicine.
Related Links:
MDI Limbach Berlin GmbH
Sebia
Abbott Core Laboratory
Roche Diagnostics
Latest Immunology News
- Diagnostic Blood Test for Cellular Rejection after Organ Transplant Could Replace Surgical Biopsies
- AI Tool Precisely Matches Cancer Drugs to Patients Using Information from Each Tumor Cell
- Genetic Testing Combined With Personalized Drug Screening On Tumor Samples to Revolutionize Cancer Treatment
- Testing Method Could Help More Patients Receive Right Cancer Treatment
- Groundbreaking Test Monitors Radiation Therapy Toxicity in Cancer Patients
- State-Of-The Art Techniques to Investigate Immune Response in Deadly Strep A Infections
- Novel Immunoassays Enable Early Diagnosis of Antiphospholipid Syndrome
- New Test Could Predict Immunotherapy Success for Broader Range Of Cancers
- Simple Blood Protein Tests Predict CAR T Outcomes for Lymphoma Patients
- Cell Sorter Chip Technology to Pave Way for Immune Profiling at POC
- Chip Monitors Cancer Cells in Blood Samples to Assess Treatment Effectiveness
- Automated Immunohematology Approaches Can Resolve Transplant Incompatibility
- AI Leverages Tumor Genetics to Predict Patient Response to Chemotherapy
- World’s First Portable, Non-Invasive WBC Monitoring Device to Eliminate Need for Blood Draw
- Predictive T-Cell Test Detects Immune Response to Viruses Even Before Antibodies Form
- Single Blood Draw to Detect Immune Cells Present Months before Flu Infection Can Predict Symptoms