Medscape Drugs & Diseases. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. URL of this page: https://medlineplus.gov/lab-tests/immunofixation-ife-blood-test/. They have a number of roles: Too much or too little protein can cause problems. The disorder occurs most commonly in older men. Among these, the committee stated that in the detection of monoclonal immunoglobulins, intact light-chain matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) mass spectrometry can be used in lieu of immunofixation in patient clinical assessments and in assessing clinical trial patients. There are several reasons a patients SPE curve could be abnormal. MGUS usually causes no problems. Ramakrishnan N, Jialal I. Bence-Jones Protein. An immunofixation blood test, also known as protein electrophoresis, measures certain proteins in the blood. Alpha-1 Antitrypsin; [updated 2019 Nov 13; cited 2019 Dec 10]; [about 2 screens]. Healthline Media does not provide medical advice, diagnosis, or treatment. Endoscopy vs. Colonoscopy: How Do They Differ? 2009. Platelets Small substances in your blood that help the blood to form a thickened mass (or blood clot) to help stop bleeding. There is very little risk to having a blood test. Available from: Cancer.Net [Internet]. We've rounded up the best at-home kidney health test kits. Multiple Myeloma: Diagnosis; 2018 Jul [cited 2019 Dec 10]; [about 3 screens]. You can also contact us directly if you need to. Diagnosis of monoclonal gammopathy of undetermined significance. Available from: Straub RH, Schradin C. Chronic inflammatory systemic diseases: An evolutionary trade-off between acutely beneficial but chronically harmful programs. Comparison of the Freelite serum free light chain (SFLC) assay with serum and urine electrophoresis/immunofixation and the N Latex FLC assay. If present, an excessive production of a monoclonal immunoglobulin may be shown in laboratory test results as a spike on a graph (M spike). Autoinflammatory vs. Autoimmune: What is the Difference? This test measures the numbers of red blood cells, white blood cells and platelets in the blood. Sometimes a CBC with differential (CBC with diff), a test that also measures the number of the different types of white blood cells present in the blood, is ordered. To use the sharing features on this page, please enable JavaScript. It may also depend on the unique patterns made by the proteins. Waldenstrom macroglobulinemia always shows a serum IgM-type monoclonal band. In zone electrophoresis, for example, different protein subtypes are placed in separate physical locations on a gel made from agar, cellulose, or other plant material.2,3 The proteins are stained, and their densities are calculated electronically to provide graphical data on the absolute and relative amounts of the various proteins. excess of an abnormal immunoglobulin called monoclonal protein (or M protein). These measurements indicate the degree to which the myeloma cells in the marrow are affecting normal blood cell development. The immunoelectrophoresis-serum test is used to. The information on this site should not be used as a substitute for professional medical care or advice. Blood. We look forward to connecting with you. Available from: National Cancer Institute [Internet]. LLS funds lifesaving blood cancer research around the world, provides free information and support services, and is the voice for all blood cancer patients seeking access to quality, affordable, coordinated care. When might mass spectrometry be used in place of immunofixation? The protein electrophoresis test is often used to find abnormal substances called M proteins. In these cases of light chain myeloma, serum test results may not show the characteristic increase of M protein (M spike), but there may be large amounts of monoclonal light chains in the urine. 1 The term monoclonal gammopathy of undetermined significance (MGUS) was coined by Dr. Robert Kyle in 1978 to describe an asymptomatic plasma cell dyscrasia characterized by a . Peaks and valleys in the bands may mean that you may be making too many or too few of certain proteins. SPEP is used to help diagnose and monitor a variety of different diseases or disorders that have abnormal proteins or protein levels. Immunofixationconsists of an electrophoresis phase and a fixation phase. There are two main types of proteins in the blood: albumin and globulin. If all tests are normal, the pattern of follow-up in Figure 36 can be undertaken. Following my rotation in Anatomical Pathology, I spent one week on accessioning review and another three in Chemistry. Your doctor may also order more tests. bone pain. 2018 Dec 3. The net charge (positive or negative) and the size and shape of the protein commonly are used in differentiating various serum proteins.1. The subgroups are: Measuring the proteins in each subgroup can help diagnose a variety of diseases. Hematocrit is a blood test that is used to determine if you have low levels of hemoglobin in your blood (a condition called anemia). Abnormal levels of certain chemicals may indicate that an organ is not working properly or they may be caused by cancer or other health conditions. When the whole immunoglobulin is present in the urine, it is usually at a low level. Diseases that produce an increase in the gamma-globulin level include Hodgkins disease, malignant lymphoma, chronic lymphocytic leukemia, granulomatous diseases, connective tissue diseases, liver diseases, multiple myeloma, Waldenstrms macroglobulinemia, and amyloidosis.3,7, Although many conditions can cause an increase in the gamma region, several disease states cause a homogeneous spike-like peak in a focal region of the gamma-globulin zone (Figure 2). Gainesville (FL): University of Florida Health; c2021. The Leukemia & Lymphoma Society (LLS) is a global leader in the fight against blood cancer. 2011. [11] HIV-related encephalitis, neurosyphilis, Lyme meningoencephalitis, neurosarcoidosis, acute disseminated encephalomyelitis (ADEM), systemic lupus erythematosus (SLE), Sjgren syndrome, subacute sclerosing panencephalitis, CNS malignancy, neuromyelitis optica, and transverse myelitis can all reveal oligoclonal banding in CSF immunofixation, precluding the use of immunofixation for the detection of oligoclonal bands as a sole diagnostic technique in multiple sclerosis. https://www.merckmanuals.com/professional/hematology-and-oncology/plasma-cell-disorders/monoclonal-gammopathy-of-undetermined-significance-mgus?query=mgus. If these examinations are normal, serum protein electrophoresis should be repeated in three to six months; if that examination is normal, serum protein electrophoresis should be repeated annually. This test is most often used to help diagnose or monitor a variety of different conditions. Electrophoresis is a lab technique used to separate groups of proteins in blood serum. Finally, when several bands with sharp borders are seen after immunofixation in cerebrospinal fluid (CSF) but not in serum, the result is reported as positive for oligoclonal bands. Available from: Lab Tests Online [Internet]. Some people may experience a rash or nerve problems, such as numbness or tingling. The Leukemia & Lymphoma Society is a 501(c)(3) organization, and all monetary donations are tax deductible to the fullest extent allowed by tax laws. If the sample is hemolyzed in vitro (red blood cells are ruptured outside the body such as during traumatic blood draw), there will be free hemoglobin, which migrates to the 1 fraction. A malignant plasma cell is called a . Immunofixation tests can also be done in urine. Finally, isolated light chain bands, either kappa or lambda, represent more commonly pure kappa or lambda light chain gammopathies or, less commonly, immunoglobulin D (IgD) or immunoglobulin E (IgE) gammopathies. If there's no disease progression, MGUS doesn't require treatment. In many myeloma patients, the coordinated process of making and attaching light chains and heavy chains fails in the malignant plasma cells. Affected patients have only one tumor, with no other bone lesions and no urine or serum abnormalities. Morris C, Drake M, Apperley J, et al. The SFLC assay can detect abnormal levels of free light chains, which may be an indication of a plasma cell disorder. The proteins are separated into 5 or 6 fractions and displayed as a curve and corresponding gel pattern. This is a normal serum protein electrophoresis (SPE) pattern; also listed are a few of the proteins associated with each fraction. Suspected multiple myeloma, Waldenstrms macroglobulinemia, primary amyloidosis, or related disorder, Unexplained peripheral neuropathy (not attributed to longstanding diabetes mellitus, toxin exposure, chemotherapy, etc. Tests are done to measure the levels of many different substances in the blood. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Copyright 2017, 2013 Decision Support in Medicine, LLC. How is a serum sample collected for an immunofixation test? Myeloma is a cancer of plasma cells, a type of white blood cell (WBC) in the bone marrow that is responsible for making immunoglobulins. You can learn more about how we ensure our content is accurate and current by reading our. The stained gel is then sent to a pathologist for diagnosis. A serum free light chain ratio is indicated in the case of a negative immunofixation result when the suspicion for multiple myeloma is still high. Protein Electrophoresis questions. The output of monoclonal protein can vary from patient to patient. [Full Text]. However, most patients with a monoclonal protein will be finally diagnosed with MGUS rather than any of the malignant plasma cell dyscrasias for which treatment is recommended. Detection of oligoclonal bands in cerebrospinal fluid by immunofixation electrophoresis. CSF immunofixation that does not reveal oligoclonal bands is also considered normal. Malabsorption; [updated 2019 Nov 11; cited 2019 Dec 10]; [about 2 screens]. Evidence of end-organ damage as defined by the CRAB criteria. A total protein test can determine whether you have high blood protein. One of the best ways to get a better sense of the SPEP test is to look at each word in the name: Serum is the liquid part of your blood. Ceruloplasmin, alpha2-macroglobulin, and haptoglobin contribute to the alpha2-protein band. Pruthi RK (expert opinion). Madison (WI):University of Wisconsin Hospitals and Clinics Authority; c2021. Arch Pathol Lab Med. This allows them to be measured and analyzed individually. https://www.uptodate.com/contents/search. Advertising revenue supports our not-for-profit mission. Bone marrow testing involves two steps usually done at the same time in a doctor's office or a hospital: The diagnosis of myeloma depends on three main findings: Revised International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma. Making sense of serum protein bands. See additional information. Synonym (s): paraprotein (2) . (2015, August 12), Serum protein electrophoresis. However, the presence of oligoclonal bands does not necessarily confirm the diagnosis, as other conditions can present with oligoclonal bands in the CSF. All rights reserved. Monoclonal gammopathy of undetermined significance (MGUS). A polyclonal immunoglobulin pattern in the serum or urine immunofixation is considered to be nonspecific. If there are not CRAB signs and/or symptoms, 60% plasma cells in the bone marrow indicates a diagnosis. The examination also should be considered in other red flag situations (Table 1).24, If the examination is normal but multiple myeloma, Waldenstrms macroglobulinemia, primary amyloidosis, or a related disorder still is suspected, immunofixation also should be performed because this technique may be more sensitive in identifying a small monoclonal (M) protein.5. Another test, calledimmunofixation or immunoelectrophoresis, is used to determine the exact type ofabnormal antibody (IgG. The IFX test can also be used to study changes in the structure of normal. There may be some slight bruising afterward. Immunofixation consists of an electrophoresis phase and a fixation phase. Serum protein electrophoresis is a laboratory examination that commonly is used to identify patients with multiple myeloma and other disorders of serum protein. Immunofixation to identify the M component as an IgM immunoglobulin with a quantitative IgM level greater than 3 g/dL. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2019. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. Copyright 2023 American Academy of Family Physicians. Diagnosis is often done with a lab test called electrophoresis. [14], Mass spectrometry is sometimes employed in place of immunofixation because of the latters limitations, such as in the detection of low-level disease. M protein is an abnormal protein caused by plasma cells. So when the Serum Protein Electrophoresis (SPEP) test shows a spike in M protein, this is a sign of MM. Electrophoresis is a method of separating proteins based on their physical properties. what does no apparent monoclonal protein on serum electrophoresis mean. Definition. Rajhumar SV. The light chain is also called the Bence Jones protein, named for the doctor Henry Bence Jones who studied its characteristics. Sasson SC, McGill K, Wienholt L, Carr A, Brown DA, Kelleher AD, et al. The test may also be performed again in the future. Albumin, the major protein component of serum, is produced by the liver under normal physiologic conditions. Mayo Clinic does not endorse companies or products. On the left a serum protein electrophoresis (SPEP) of a patient with a monoclonal band in the gamma region is shown. Continuing Medical Education (CME/CE) Courses. Peripheral blood smear often shows RBC aggregates in a rouleaux formation. Available from: National Cancer Institute [Internet]. The remainder had hypogammaglobulinemia or a normal-appearing pattern. IgA or some other type). . 25th ed. Am J Clin Pathol. [7], The identification of oligoclonal bands in CSF is helpful in the diagnosis of multiple sclerosis. Both types of blood cells (red and white) and platelets are solids. A C-reactive protein test, or CRP test, measures the amount of CRP in your. Monoclonal gammopathy of undetermined significance. Symptoms and Causes Diagnosis and Tests Management and Treatment Prevention Outlook / Prognosis Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: multiple myeloma; [cited 2019 Dec 10]; [about 3 screens]. Common causes of high levels include: Low protein levels may be caused by many conditions. Instead, its used along with other laboratory tests to provide more information to help with diagnosis. The most common type of myeloma is IgG kappa, occurring in approximately 52 % of patients. A second screen is used to confirm positive test results. These proteins can also be referred to as an M-spike, monoclonal immunoglobulin, or paraprotein. Alexandria (VA): American Society of Clinical Oncology; 20052019. Affected patients have no lytic bone lesions, no anemia, no hypercalcemia, and no renal disease. Heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients. 2015 May. ; 2014 Mar 14 [cited 2020 Jan 22]; [about 3 screens]. The presence of M proteins can be a sign of a type of cancer called myeloma, or multiple myeloma. MGUS causes no symptoms. Moving toward the negative portion of the gel (i.e., the negative electrode), the next peaks involve the alpha1 and alpha2 components. Sometimes, however, the results of this examination can be confusing or difficult to interpret. Murray DL, Puig N, Kristinsson S, et al. Quantitative determination of the serum M component to demonstrate that an IgG or IgM monoclonal protein is less than 3.0 g/dL or an IgA monoclonal protein is less than 2.0 g/dL, or that a Bence-Jones protein is less than or equal to 1.0 g in a 24-hour urine specimen. Immune Thrombocytopenia Purpura (ITP): What helps? [1] In the former, the serum is applied to an agarose gel, and the negatively charged serum proteins move toward the cathode under the influence of an electric current. The various proteins in the body perform different functions. [Full Text]. Share cases and questions with Physicians on Medscape consult. Rajhumar SV. For patients with MGUS and high risk for progression to multiple myeloma, surveillance should be performed at 6 months and then yearly thereafter. Figure 1 shows a typical normal pattern for the distribution of proteins as determined by serum protein electrophoresis. 2019 Jan. [QxMD MEDLINE Link]. National Multiple Sclerosis Society; MS Symptoms; [cited 2019 Dec 18]; [about 3 screens]. In contrast, polyclonal gammopathies may be caused by any reactive or inflammatory process, and they usually are associated with nonmalignant conditions. Retrieved from, Understanding serum protein electrophoresis, What abnormal results for SPEP test may mean, How test results may be used to decide future care, urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=protein_electrophoresis_serum, labtestsonline.org/understanding/analytes/electrophoresis, Serum Thyroxine-Binding Globulin (TBG) Level Test, Everything You Should Know About a Hair Strand Drug Test, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Affected patients have no M protein in their urine, no lytic bone lesions, no anemia, no hypercalcemia, and no renal disease. Bird J, Behrens J, Westin J, et al. Serum protein electrophoresis is used to identify patients with multiple myeloma and other serum protein disorders. If you log out, you will be required to enter your username and password the next time you visit. [9], In addition, immunofixation can be used to monitor therapy in plasma cell dyscrasias (ie, multiple myeloma and Waldenstrom macroglobulinemia). Much of the clinical interest is focused on the gamma region of the serum protein spectrum because immunoglobulins migrate to this region. Available from: Maine Health [Internet]. Connect with others like you for support and answers to your questions in the Blood Cancers & Disorders support group on Mayo Clinic Connect, a patient community. The alpha1-protein fraction is comprised of alpha1-antitrypsin, thyroid-binding globulin, and transcortin. This allows them to be measured and analyzed individually. An apparent monoclonal protein on serum protein electrophoresis may or may not be a true monoclonal protein. Monoclonal protein (M protein) levels can be measured in blood and/or urine samples,and these levels generally correlate with the extent of the myeloma. Then it says: "The SPE pattern appears essentially unremarkable. The peaks for these components lie toward the negative electrode, with the gamma peak being closest to that electrode. If a monoclonal protein is present, a precipitant will form at this phase. Serum protein electrophoresis is an inexpensive, easy-to-perform screening procedure for initial identification of monoclonal bands. Common causes of low levels include: Your diagnosis will depend on which specific protein levels were not normal, and whether the levels were too high or too low. Philadelphia, PA, USA: Elsevier Churchill Livingstone; 2008. chapter 87. Kyle RA, Durie BG, Rajkumar SV, et al. Skeletal lesions (e.g., lytic lesions, diffuse osteopenia, vertebral compression fractures) are present in 80 percent of patients. Tax Identification Number: 13-5644916, Myeloma Guide: Information for Patients and Caregivers, A bone marrow aspirationto remove a liquid marrow sample, A bone marrow biopsyto remove a small amount of bone filled with marrow, Malignant plasma cells: Plasma cell level of >10% in a bone marrow biopsy sample, Unusually large amounts of monoclonal protein (called an M spike). Immunofixation in CSF for the detection of oligoclonal bands is indicated every time there is suspicion for multiple sclerosis. But sometimes it can progress to more-serious diseases, including some forms of blood cancer. The article also provides a simple guide to result interpretation and suggestions on follow-up of abnormal results. Because MGUS is not harmful, it doesn't need to be treated. In: Goldman-Cecil Medicine. If serum protein electrophoresis is abnormal at any time during the follow-up, a referral should be made. 1976. Monoclonal gammopathies are conditions in which abnormal proteins are found in the blood. [QxMD MEDLINE Link]. No monoclonal protein detected M-PROTEIN ISOTYPE MALDI-TOF MS FLAG Negative Interpretation Monoclonal Gammopathies: -A characteristic monoclonal band (M-spike) is often found on serum protein electrophoresis (SPE) in the gamma globulin region and, more rarely, in the beta or alpha-2 regions. Monoclonal antibodies could be used as myeloma treatments and can be identified by serum protein electrophoresis and immunofixation electrophoresis. Serum protein electrophoresis (SPEP) is a test that measures theantibodies in the blood and can find a monoclonal antibody. Ronald Hoffman, Leslie E. Silberstein, Sanford J. Shattil, Bruce Furie, Philip McGlave. Monoclonal gammopathy of undetermined significance (MGUS). However, blood has several components. CBC often reveals a normochromic normocytic anemia. John C Leighton, Jr, MD, FACP Clinical Associate Professor, Jefferson Medical College of Thomas Jefferson University; Chief, Division of Medical Oncology, Jeanes Hospital; Associate Director, Associate Chief, Divisions of Hematology/Medical Oncology, Albert Einstein Cancer Center; Associate Member Kimmel Cancer Center, Thomas Jefferson Hospital What are considerations regarding immunofixation results in multiple myeloma, and what are the limitations of a 24-hour concentrated urine sample for immunofixation testing? Urine immunoelectrophoresis is a lab test that measures immunoglobulins in a urine sample. Washington D.C.: American Association for Clinical Chemistry; c20012019. 2017 Dec 28. 135:1048-51. 2010. No abstract available. This article provides a comprehensive review of serum protein electrophoresis, including a discussion of how the examination is performed, what it measures, and when it is indicated. The patient urinates each time into a clean dry vessel and then pours the urine in the plastic container, which is kept at a cold temperature (eg, in the refrigerator). Beaumont-Epinette MP, Moreau C, Besnard S, Latute F, Collet N, Sebillot M, et al. Instead, they only make light chains. If multiple myeloma still is considered clinically in a patient who does not have an M-protein spike on serum protein electrophoresis, urine protein electrophoresis should be performed. Typically present in low amounts, conditions such as multiple myeloma and Waldenstrms macroglobulinemia show proliferation of abnormal or cancerous plasma cells. When screening a patient or establishing a first-time diagnosis for a monoclonal gammopathy, consider ordering DMOGA / Monoclonal Gammopathy, Diagnostic, Serum instead, which includes free light chain analysis. Peripheral blood smear often shows RBCs in a stacked or rouleaux formation. In some patients, the myeloma cells do not make a complete monoclonal immunoglobulin molecule with two heavy and two light chains. A normal result includes a darker immunoglobulin G (IgG) lane, a lighter immunoglobulin A (IgA), an absent immunoglobulin M (IgM), and a denser kappa compared to lambda lane, with ratio of 2:1. In addition, doctors stagemyeloma to help them decide on the best treatmentplan. [2] : Monoclonal gammopathy of undetermined significance (MGUS) Less than 10% plasma cells are present in bone marrow, and patients have no lytic bony lesions, anemia, hypercalcemia, or renal insufficiency. Genetic changes and environmental triggers appear to play a role. If the serum M-protein spike is 1.5 to 2.5 g per dL, it is important to perform nephelometry to quantify the immunoglobulins present and to obtain a 24-hour urine collection for electrophoresis and immunofixation. A total protein test is often done as part of your regular checkup. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. Learn more about laboratory tests, reference ranges, and understanding results. Inflammatory diseases include. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Yang G, Geng C, Chen W. Clinical characteristics of a group of patients with multiple myeloma who had two different light chains by immunofixation electrophoresis: A retrospective study from a single center. The next most common type is light chain myeloma in which no intact immunoglobulin is produced. Next-Generation Sequencing (NGS). 2015 Oct. 47 (6):564-9. The procedure was nearly identical to one of our labs at BCIT, so Im glad to have had a bit of experience in preparing the gel and dispensing the antisera. Monoclonal gammopathy of undetermined significance (MGUS) (adult). 2019 Jun 20. Rarely, plasma cells can enter into the circulation and if they represent 20 percent or more of the blood cells, the condition is called plasma cell leukemia. Note that the percent of plasma cells in the bone marrow, assessed by flow cytometry, is not the value used in the diagnostic criteria above. This sample is often difficult to collect, and suboptimal collection might alter the result. A colonoscopy is specifically used to look at the colon. There are various types of these proteins that fight different types of infections. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel. In blood cancers such as myeloma, the 'M' in 'M protein' stands for monoclonal. When there is damage to the kidneys, other proteins, such as albumin, may also be present in the urine. [9], Surveillance among patients with MGUS or smoldering (asymptomatic) multiple myeloma, Immunofixation of the urine and serum should be included in a battery of tests after 2-3 months following diagnosis of smoldering myeloma, then every 4-6 months for 1 year, and, finally, every 6-12 months if the results are stable. Protein electrophoresis serum : Overview; [updated 2021 Aug 9; cited 2021 Aug 9]; [about 2 screens]. This whole (intact) immunoglobulin, made of the four chains, is usually too large to pass through the kidney. The gamma-globulin zone is decreased in hypogammaglobulinemia and agammaglobulinemia. It should be noted that immunoglobulins often can be found throughout the electrophoretic spectrum. In particular, when serum and urine protein electrophoresis results are negative, immunofixation is indicated as a more sensitive test if the clinical suspicion remains high. Urbancek S, Gascon P, Schwartz RA, Jacobson DR, Buxbaum JN, Bogdan CA. This is serum. 2019 May 23. Our website services, content, and products are for informational purposes only. No monoclonal band is identified. These tests are done in conjunction with immunofixation for example, serum immunofixation electrophoresis (SIFE), which identifies immunoglobulins in blood samples. [16]. Available from: National Heart, Lung, and Blood Institute [Internet]. Chromosomal abnormalities play a crucial role in identifying cancerous cells and determining the risk of relapse. AskMayoExpert. The pattern of serum protein electrophoresis results depends on the fractions of two major types of protein: albumin and globulins. When is an immunofixation test indicated? [QxMD MEDLINE Link]. Ferri FF. Immunoglobulins, known as Igs, are a group of proteins that help protect your body from illness. 2018 Sep 7. Keep in mind that these are just clues. What does "polyclonal light chains detected but no monoclonal immunoglobilin or free light chain (bencejones) is MD presence of free light chain in urine is diagnostic of multiple myeloma.Multiple myeloma is a type of cancer that is caused by malignant plasma cells that proliferate in the bone marrow and produce abnormally high amounts. This pattern represents the presence of polyclonal immunoglobulin. In the interpretation of serum protein electrophoresis, most attention focuses on the gamma region, which is composed predominantly of antibodies of the IgG type. Your story might just end up on BCIT News. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: lymphoma; [cited 2019 Dec 10]; [about 3 screens]. A polyclonal gammopathy is characterized by a broad diffuse band with one or more heavy chains and kappa and lambda light chains.7, Once a monoclonal gammopathy is identified by serum protein electrophoresis, multiple myeloma must be differentiated from other causes of this type of gammopathy. Follow-up of multiple myeloma, Waldenstrom macroglobulinemia, and AL amyloidosis, Immunofixation of urine and serum samples should be performed in all patients with multiple myeloma, Waldenstrom macroglobulinemia, and AL amyloidosis every 3 months after the completion of treatment in order to evaluate for response or to document a relapse.

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