Mass Spectrometry Methods Transform M-Protein Detection and MRD Monitoring in Myeloma
This review provides a comprehensive overview of mass spectrometry-based methods for detecting, characterizing, and quantifying monoclonal proteins in plasma cell disorders. MS approaches -- including top-down, middle-down, and bottom-up strategies -- overcome limitations of traditional electrophoretic methods, particularly therapeutic antibody interference and insufficient sensitivity for MRD assessment. The authors discuss how MS-based M-protein diagnostics will impact clinical practice as novel myeloma treatments demand increasingly sensitive response monitoring.
The original study
Mass Spectrometry for Identification, Monitoring, and Minimal Residual Disease Detection of M-Proteins.
- Authors
- Zajec M, Langerhorst P, VanDuijn MM, Gloerich J, Russcher H, van Gool AJ, et al.
- Journal
- Clinical chemistry
- Type
- Journal Article, Research Support, Non-U.S. Gov't, Review
- PMID
- 32031591
Original abstract
BACKGROUND: Monoclonal gammopathies (MGs) are plasma cell disorders defined by the clonal expansion of plasma cells, resulting in the characteristic excretion of a monoclonal immunoglobulin (M-protein). M-protein detection and quantification are integral parts of the diagnosis and monitoring of MGs. Novel treatment modalities impose new challenges on the traditional electrophoretic and immunochemical methods that are routinely used for M-protein diagnostics, such as interferences from therapeutic monoclonal antibodies and the need for increased analytical sensitivity to measure minimal residual disease. CONTENT: Mass spectrometry (MS) is ideally suited to accurate mass measurements or targeted measurement of unique clonotypic peptide fragments. Based on these features, MS-based methods allow for the analytically sensitive measurement of the patient-specific M-protein. SUMMARY: This review provides a comprehensive overview of the MS methods that have been developed recently to detect, characterize, and quantify M-proteins. The advantages and disadvantages of using these techniques in clinical practice and the impact they will have on the management of patients with MGs are discussed.