Reporting of paraprotein concentrations in individuals with B-cell malignancies such as multiple myeloma provides a useful surrogate marker for monitoring the levels of the malignant cell population in an individual patient. Testing is usually performed using agarose gel or capillary electrophoretic methods. National guidelines for the standardised reporting of protein electrophoresis in Australia and New Zealand (ANZ) advocate the measurement of immunoglobulins (Ig) by immunochemical methods, namely immuno-nephelometric (INA) or immunoturbidometric (ITA) assays, to monitor paraprotein levels when the abnormal paraprotein band overlays normal serum proteins (e.g., an IgA paraprotein in the β-fraction). Furthermore, the guidelines state that, “It is desirable that laboratories perform a comparison of their quantitative electrophoresis and immunochemical method for monoclonal IgG, IgA and IgM that migrate in the γ-region to determine the upper limit of agreement for monoclonal Igs measured by INA/ITA methods”. In this ePoster, I report on the evaluation of the level of agreement between these assays in my institution as per these recommendations, including the impact of “gating” settings on albumin estimations by electrophoresis and correlation between calculated globulins, reported as part of liver function testing, and the non-albumin (globulin) fractions reported in electrophoresis testing.
Robin Williams (Sun,) studied this question.