Multiple myeloma: Detection of free monoclonal light chains by modified immunofixation electrophoresis with antisera against free light chains

Dorian Wilhite, Ahmed Arfa, Thomas Cotter, Natasha M. Savage, Roni J. Bollag, Gurmukh Singh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Neoplastic monoclonal gammopathies are frequently associated with production of excess free monoclonal light chains. A sensitive method for detecting free monoclonal light chains in serum could provide a marker for residual/minimal residual disease and as an adjunct to serum protein electrophoresis to serve as a screening method for monoclonal gammopathies. Methods: Conventional serum immunofixation electrophoresis was modified by applying undiluted serum samples, and staining for serum free light chains with antisera specific to free light chains. Washing/blotting of gels was enhanced to remove residual proteins that did not bind to the antibodies including intact monoclonal immunoglobulins. Results from this modified immunofixation electrophoresis were compared with results from commercially available MASS-FIX/MALDI assay. Results: Monoclonal free kappa light chains could be detected to a concentration of about 1.78 mg/L and monoclonal free lambda light chains to a concentration of about 1.15 mg/L without the need for special equipment. Comparison of these thresholds with parallel results from a commercially available MASS-FIX/MALDI assay revealed the modified electrophoretic method to be more sensitive in the context of free monoclonal light chains. Conclusions: Modified serum immunofixation electrophoresis has been shown to detect low levels of monoclonal free light chains at a sensitivity suitable for the method to be used in detecting minimal residual disease, and potentially in a screening assay for monoclonal gammopathies. The disparity in the results with commercially available MASS-FIX/MALDI assay is postulated to be due to limited repertoire of reactivity of nanobodies of camelid origin.

Original languageEnglish (US)
Article numbere00256
JournalPractical Laboratory Medicine
Volume27
DOIs
StatePublished - Nov 2021
Externally publishedYes

Keywords

  • FLC-Modified SIFE
  • Light chain myeloma
  • Light chain predominant multiple myeloma
  • MASS-FIX/MALDI
  • Minimal residual disease
  • Monoclonal light chains
  • Multiple myeloma
  • Serum free light chains

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Clinical Biochemistry

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