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BACKGROUND: We analyzed serial data in patients with clinically stable monoclonal gammopathy to determine the total variation of serum M-spikes (measured with serum protein electrophoresis (SPEP)), urine M-spikes (measured with urine protein electrophoresis (UPEP)), and monoclonal serum free light chain (FLC) concentrations measured with immunoassay. METHODS: Patients to be studied were identified by ( a ) no treatment during the study interval, ( b ) no change in diagnosis and <5 g/L change in serum M-spike over the course of observation; ( c ) performance of all 3 tests (SPEP, UPEP, FLC immunoassay) in at least 3 serial samples that were obtained 9 months to 5 years apart; ( d ) serum M-spike 10 g/L, urine M-spike 200 mg/24 h, or clonal FLC 100 mg/L. The total CV was calculated for each method. RESULTS: Among the cohort of 158 patients, 90 had measurable serum M-spikes, 25 had urine M-spikes, and 52 had measurable serum FLC abnormalities. The CVs were calculated for serial SPEP M-spikes (8.1%), UPEP M-spikes (35.8%), and serum FLC concentrations (28.4%). Combining these CVs and the interassay analytical CVs, we calculated the biological CV for the serum M-spike (7.8%), urine M-spike (35.5%), and serum FLC concentration (27.8%). CONCLUSIONS: The variations in urine M-spike and serum FLC measurements during patient monitoring are similar and are larger than those for serum M-spikes. In addition, in this group of stable patients, a measurable serum FLC concentration was available twice as often as a measurable urine M-spike. Related articles in Clinical Chemistry: Improved Monitoring of Differences in Serial Laboratory Results Callum G. Fraser Clinical Chemistry 2011 57: 1635-1637. (Extract) (Full Text) The following articles in journals at HighWire Press have cited this article: C. G. Fraser Improved Monitoring of Differences in Serial Laboratory Results Clin. Chem., December 1, 2011; 57(12): 1635 - 1637. (Full Text) (PDF) Copyright © 2011 by the American Association for Clinical Chemistry. var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); var pageTracker = _gat._getTracker("UA-5821081-1"); pageTracker._trackPageview();

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Long-Term Biological Variation of Serum Protein Electrophoresis M-Spike, Urine M-Spike, and Monoclonal Serum Free Light Chain Quantification: Implications for Monitoring Monoclonal Gammopathies

Katzmann, Jerry A.; Snyder, Melissa R.; Rajkumar, S. Vincent; Kyle, Robert A.; Therneau, Terry M.; Benson, Joanne T.; Dispenzieri, Angela
Clinical Chemistry , Volume 57 (12): 1687
American Association for Clinical Chemistry – Dec 1, 2011

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