Therapeutic monoclonal antibodies seen on protein electrophoresis

“

The field of therapeutic monoclonal antibodies is growing and there will be more and more of these therapies that may impact laboratory test results for patients undergoing therapy with these drugs. In the field of myeloma, that will be particularly important since patients with myeloma are monitored using protein electrophoresis and immunofixation while on therapy with monoclonal antibodies, so distinguishing between residual disease and visualization of the drug is extremely important. This study focuses on more common mAbs, used for autoimmune inflammatory disorders. Patients taking these drugs not always have electrophoresis done as part of their routine monitoring, but when they do, and we see the therapeutic mAb migrating on the gel and report that as a monoclonal protein, that may create unnecessary anxiety and further investigations for a monoclonal gammopathy of undetermined significance, amyloidosis, or other diseases. The method our group developed may help clarify whether the protein is endogenous or therapy, and states at which concentrations there may be an issue.

”