High-Resolution Mass Spectrometry for Diagnosing and Monitoring Plasma Cell Disorders

Mass spectrometry (MS) methods have emerging use in plasma cell disorder diagnosis and monitoring, particularly in measurable residual disease (MRD)-adjacent monitoring and in resolving therapeutic monoclonal antibody interference. We have developed a liquid chromatography high-resolution mass spectrometry (LC-HRMS) assay for simultaneous quantitation of patient-specific monoclonal immunoglobulins and therapeutic monoclonal antibodies, with single-digit mg/L range sensitivity. This work is forming the basis of a prospective validation study to assess the analytical and clinical performance of LC-HRMS and matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) MS, with evaluation domains including workflows and scalability.