Interpretation difficulties in electrophoresis and immunofixation findings in patients with multiple myeloma after autologous transplantation

Czech version

Authors: P. Kušnierová ^1,2; D. Zeman ^1,2; R. Šigutová ^1,2; Z. Švagera ^1,2; L. Zahradová ^3,4; R. Hájek ^3,4
Authors‘ workplace: Ústav laboratorní diagnostiky, Oddělení klinické biochemie, Fakultní nemocnice Ostrava ¹; Katedra biomedicínských oborů, Lékařská fakulta, Ostravská univerzita ²; Klinika hematoonkologie, Fakultní nemocnice Ostrava ³; Katedra interních oborů, Lékařská fakulta, Ostravská univerzita ⁴
Published in: Klin. Biochem. Metab., 25, 2017, No. 2, p. 59-63

Overview

Objective:
The study of abnormal gradients including new monoclonal immunoglobulins and oligoclonal bands in patients with multiple myeloma after autologous transplantation

Design:
Retrospective study.

Material and Methods:
100 multiple myeloma patients after autologous transplantation between November 2013 and August 2016 from the Clinic of Haematooncology, University Hospital Ostrava, were included in the study. For the identification and quantification of paraproteins, standard serum protein electrophoresis and immunofixation electrophoresis were used. Exceptionally, in case of equivocal results, agarose isoelectric focusing with subsequent affinity-mediated immunoblotting was performed.

Results:
Changes in immunofixation result were observed 2 months (mean; range 1-8 months) after the autologous transplantation in 46 % of patients. In 6 (13%) of them isotype switch was observed, in 17 (37 %) transient oligoclonal profile, and in 23 (50 %) isotype shift as well as transient oligoclonal profile. Return towards the original immunofixation result was observed 14 months (mean; range 4-32 months) after the autologous transplantation.

Conclusion:
Observation of new monoclonal gradients or transient presence of oligoclonal bands in patients after autologous transplantation probably represents a transient phenomenon linked to the recovery of immunoglobulin production without any negative clinical significance in sense of a disease relapse.

Keywords:
serum protein electrophoresis, immunofixation electrophoresis, isoelectric focusing, monoclonal immunoglobulin, oligoclonality, multiple myeloma.

Sources

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Article was published in

Clinical Biochemistry and Metabolism

2017 Issue 2