Mitigating the interference of Daratumumab with immunofixation electrophoresis. A single-center experience using Hydrashift 2/4 kit.

Autor:	Duek A; Department of Hematology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Lellouche E; Biochemistry Laboratory, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Ben Baruch S; Department of Hematology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Mashiach R; Biochemistry Laboratory, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Segman Y; Department of Hematology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Bryk G; Department of Hematology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel., Leiba M; Department of Hematology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Jazyk:	angličtina
Zdroj:	The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2022 Oct; Vol. 24 (10), pp. 629-633.
Abstrakt:	Background: Multiple myeloma (MM) accounts for approximately 10% of hematological malignancies. The monoclonal immunoglobulin G kappa (IgG-κ) daratumumab can bind to CD38 on MM cells and be detected in serum immunofixation (IF), causing pitfalls in M-protein quantification. Objectives: To determine the efficacy of mitigating the interference of IgG MM treated with daratumumab. Methods: Levels of Ig, free light chains (FLC) kappa (κ) and lambda (λ), serum protein electrophoresis (SPE)/IF, and Hydrashift 2/4 assays were assessed following manufacturer's instructions in three patients. Results: Patient 1 was a 70-year-old male diagnosed with IgG-λ MM. The IF distinguished two monoclonal bands (IgG-κ and IgG-λ). With the Hydrashift assay, the daratumumab-anti-daratumumab immune complex shifted the IgG-κ to the α zone, suggesting that the monoclonal IgG-κ band corresponded to daratumumab. Patient 2 was a 63-year-old male with IgG-κ MM who was receiving daratumumab once every other week. SPE/IF assay revealed a faint monoclonal IgG-κ band in the  zone. A stronger monoclonal band was observed after administration. The IgG-κ band disappeared on the Hydrashift assay, while the daratumumab-anti-daratumumab complex appeared as a broad smear in the α-region. Patient 3, a 63-year-old male diagnosed with IgG-λMM, was receiving daratumumab once every other month. The IF assay showed two distinct bands (IgG-κ and IgG-λ) post-daratumumab administration. The shift to the α zone of the IgG-κ bands on the Hydrashift assay confirmed that the additional band observed post-infusion was due to the daratumumab. Conclusions: The Hydrashift assay can help distinguish daratumumab from endogenous M-spike.
Databáze:	MEDLINE
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