Myeloma, Minimal Residual Protein Detection Panel

The primary purpose of this test is to detect minimal residual disease in a patient with a known monoclonal protein or to establish a UW laboratory diagnosis of a known M-spike.

This test may also be useful for amyloidosis screening. The International Myeloma Working Group recommends that screening for AL amyloidosis include the following tests: serum protein electrophoresis, serum and urine immunofixation, and serum free light chains (FLC) (Dispenzieri et al, Leukemia (2009) 23:215. https://pubmed.ncbi.nlm.nih.gov/19020545/).

The initial test performed is serum protein electrophoresis. Samples with a monoclonal band present on protein electrophoresis that has previously been identified in this laboratory will be resulted with the concentration of the known M-spike, without further testing. Samples demonstrating previously unidentified protein bands of concern will be tested by immunofixation. If a monoclonal band is identified by immunofixation, its concentration will be reported.

If no monoclonal band is identified by protein electrophoresis, an immunofixation test will automatically be performed. If no monoclonal band is identified by electrophoresis or immunofixation, the specimen will be reflexively tested for serum free light chain concentrations (FLC). All reflexive tests will generate additional results and charges.