Method comparison for serum protein electrophoretic M‐protein quantification: Agarose gel electrophoresis and capillary zone electrophoresis in canine and feline sera

2021 ◽  
Author(s):  
Christina M. Jeffries ◽  
R Adam Harris ◽  
Laura Ashton ◽  
A Russell Moore
Keyword(s):  
Capillary Zone Electrophoresis ◽  
Serum Protein ◽  
Gel Electrophoresis ◽  
Method Comparison ◽  
Protein Quantification ◽  
M Protein ◽  
Agarose Gel ◽  
Agarose Gel Electrophoresis ◽  
Zone Electrophoresis ◽  
Capillary Zone

Measurement of serum monoclonal components: comparison between densitometry and capillary zone electrophoresis

2006 ◽  
Vol 44 (5) ◽  
Author(s):  
Michele Mussap ◽  
Francesco Pietrogrande ◽  
Silvia Ponchia ◽  
Piero Maria Stefani ◽  
Roberto Sartori ◽  
...  
Keyword(s):  
Capillary Zone Electrophoresis ◽  
Quantitative Measurement ◽  
Protein Quantification ◽  
M Protein ◽  
Agarose Gel ◽  
Altman Analysis ◽  
Monoclonal Gammopathies ◽  
M Proteins ◽  
Zone Electrophoresis ◽  
Capillary Zone

AbstractQuantitative measurement of serum monoclonal protein (M-protein) is one of the most important tools for monitoring disease activity in monoclonal gammopathies. The aims of this study were to evaluate serum M-protein quantification by capillary zone electrophoresis (CZE) and to compare results with those obtained by densitometric scanning of high-resolution agarose gel electrophoresis (HRE-AGE). The evaluation was carried out on 82 samples from patients with various monoclonal gammopathies. All the suspected M-proteins were confirmed and characterised by immunofixation on agarose gel (IFE). CZE was performed on a Paragon CZE™ 2000 system (Beckman Coulter). Passing-Bablok regression was: y (CZE)=1.27×(HRE-AGE)–5.21g/L. The correlation coefficient was 0.92. Bland-Altman analysis demonstrated a mean difference of −1.83g/L (95% CI −0.76 to −2.90) with clear evidence of a concentration-related bias. Densitometry gave higher values at low M-spikes (<20g/L), whereas CZE gave higher values at large M-spikes (>20g/L). The concentration-related bias was found to be independent of the immunoglobulin isotype. In conclusion, to compare previous results obtained by M-protein densitometric scanning with those obtained by direct measurement of CZE peaks, the calculation of a univocal transforming factor appears to be unreliable.

Case report: Interference from isatuximab on serum protein electrophoresis prevented demonstration of complete remission in a myeloma patient

2021 ◽  
pp. 000456322110620
Author(s):  
Rachel D Wheeler ◽  
Micsha V Costa ◽  
Asante Crichlow ◽  
Fenella Willis ◽  
Yasmin Reyal ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Complete Remission ◽  
Capillary Zone Electrophoresis ◽  
Serum Protein ◽  
Plasma Cells ◽  
Survival Rates ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Zone Electrophoresis ◽  
Capillary Zone

Multiple myeloma is a haematological cancer caused by malignant plasma cells in the bone marrow that can result in organ dysfunction and death. Recent novel treatments have contributed to improved survival rates, including monoclonal antibody therapies that target the CD38 protein on the surface of plasma cells. Anti-CD38 therapies are IgG kappa monoclonal antibodies that are given in doses high enough for the drug to be visible on serum protein electrophoresis as a small paraprotein. We present a case where isatuximab, the most recent anti-CD38 monoclonal antibody to be approved for treatment of myeloma, obscured the patient’s paraprotein on gel immunofixation, so that complete remission could not be demonstrated. This was resolved using the isatuximab Hydrashift assay. The interference on gel immunofixation was unexpected because isatuximab migrated in a position distinct from the patient’s paraprotein on capillary zone electrophoresis. We demonstrate the surprising finding that isatuximab migrates in a different position on gel electrophoresis compared to capillary zone electrophoresis. It is vital that laboratories are aware of the possible interference on electrophoresis from anti-CD38 monoclonal antibody therapies, and are able to recognise these drugs on protein electrophoresis. The difference in isatuximab’s electrophoretic mobility on capillary and gel protein electrophoresis makes this particularly challenging. Laboratories should have a strategy for alternative analyses in the event that the drugs interfere with assessment of the patient’s paraprotein.

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