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Old but Still Relevant: High Resolution Electrophoresis and Immunofixation in Multiple Myeloma

  • Aroonima Misra
  • Jyoti Mishra
  • Jagan Chandramohan
  • Atul Sharma
  • Vinod Raina
  • Rajive Kumar
  • Sushant Soni
  • Anita ChopraEmail author
Review Article

Abstract

Introduction: High resolution electrophoresis (HRE) and immunofixation (IFX) of serum and urine are integral to the diagnostic work-up of multiple myeloma. Unusual electrophoresis patterns are common and may be misinterpreted. Though primarily the responsibility of the hematopathologist, clinicians who are responsible for managing myelomas may benefit from knowledge of these. In this review article we intend to discuss the patterns and importance of electrophoresis in present day scenario. Methods: Patterns of HRE and IFX seen in our laboratory over the past 15 years were studied. Results: Monoclonal proteins are seen on HRE as sharply defined bands, sometimes two, lying from γ- to α-globulin regions on a background of normal, increased or decreased polyclonal γ-globulins, showing HRE to be a rapid and dependable method of detecting M-protein in serum or urine. Immunofixation complements HRE and due to its greater sensitivity, is able to pick up small or light chain bands, not apparent on electrophoresis, including biclonal disease even when electrophoresis shows only one M-band. Special features liable to misinterpretation are discussed. Familiarity with the interpretation of the varied patterns seen in health and disease is essential for providing dependable laboratory support in the management of multiple myeloma.

Keywords

High resolution electrophoresis Immunofixation Myeloma 

Notes

Acknowledgments

Grateful thanks are due to Professors RA Kyle and PR Greipp and other members of the Dyspro Row at Mayo Clinic, Rochester, USA, for help received in setting up our laboratory.

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Copyright information

© Indian Society of Haematology & Transfusion Medicine 2015

Authors and Affiliations

  • Aroonima Misra
    • 1
  • Jyoti Mishra
    • 1
  • Jagan Chandramohan
    • 1
  • Atul Sharma
    • 2
  • Vinod Raina
    • 2
  • Rajive Kumar
    • 1
  • Sushant Soni
    • 1
  • Anita Chopra
    • 1
    Email author
  1. 1.Room No. 423, 4th Floor, Laboratory Oncology, Dr. BRA-IRCHAIIMSNew DelhiIndia
  2. 2.Medical Oncology, Dr.BRA-IRCHAIIMSNew DelhiIndia

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