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首页> 外文期刊>Journal of Clinical Medicine Research >Oligoclonal Pattern/Abnormal Protein Bands in Post-Treatment Plasma Cell Myeloma Patients: Implications for Protein Electrophoresis and Serum Free Light Chain Assay Results
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Oligoclonal Pattern/Abnormal Protein Bands in Post-Treatment Plasma Cell Myeloma Patients: Implications for Protein Electrophoresis and Serum Free Light Chain Assay Results

机译：治疗后血浆细胞骨髓瘤患者的寡克隆模式/异常蛋白带：对蛋白质电泳和血清游离轻链测定结果的启示

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Background: The impact of autologous stem cell transplantation (ASCT) in plasma cell myeloma patients on the frequency, quality, and timing of oligoclonal pattern in serum protein electrophoresis/immunofixation electrophoresis (SPEP/SIFE) and serum free light chain assay (SFLCA) was evaluated.Methods: Laboratory results and clinical data for 251 patients with plasma cell myeloma, who had SPEP/SIFE and/or SFLCA performed between January 2010 and December 2016 were reviewed. The results for SPEP/SIFE and SFLCA were compared in patients with ASCT to those without ASCT. The implications of oligoclonal pattern in interpretation of SPEP/SIFE and SFLCA - κ/λ ratio were addressed.Results: In 251 patients, a total of 3,134 observations, of either SPEP/SIFE and/or SFLCA, were reviewed. One hundred fifty-nine patients received ASCT. The incidence of oligoclonal patterns was significantly higher after ASCT. More than half of the oligoclonal patterns developed in the first year after transplantation. In 13 of the 84 patients with lambda chain restricted plasma cell myeloma, the κ/λ ratio was kappa dominant in the presence of oligoclonal pattern. There was no reversal of κ/λ ratio in patients with kappa chain restricted plasma cell myelomas.Conclusions: ASCT is associated with significantly higher incidence of oligoclonal patterns than with chemotherapy alone. The presence of oligoclonal patterns has the potential to interfere with the interpretation of SPEP/SIFE and ascertainment of complete remission. At a minimum, the oligoclonal pattern caused an incorrect kappa dominant κ/λ ratio in 15.5% of patients with lambda chain restricted plasma cell myeloma. If a similar rate were to be applied to the 167 kappa chain myeloma patients, about 26 of these would have displayed an erroneous kappa chain dominant κ/λ ratio. The presence of oligoclonal pattern further degrades the performance of already dubious SFLCA. The need for recording the location of monoclonal spike in SPEP/SIFE and higher resolution protein electrophoresis methods are highlighted.J Clin Med Res. 2017;9(8):671-679doi: https://doi.org/10.14740/jocmr3049w
机译：背景：浆细胞骨髓瘤患者自体干细胞移植（ASCT）对血清蛋白电泳/免疫固定电泳（SPEP / SIFE）和血清游离轻链测定（SFLCA）中寡克隆模式的频率，质量和时间的影响是方法：回顾性分析2010年1月至2016年12月间进行SPEP / SIFE和/或SFLCA的251例浆细胞性骨髓瘤患者的实验室检查结果和临床数据。比较了ASCT患者和非ASCT患者的SPEP / SIFE和SFLCA结果。结果表明：在251例患者中，共审查了3,134例SPEP / SIFE和/或SFLCA观察结果，其中寡克隆模式对解释SPEP / SIFE和SFLCA-κ/λ比具有重要意义。 159例患者接受了ASCT。 ASCT后寡克隆模式的发生率明显更高。一半以上的寡克隆模式发生在移植后的第一年。在84例lambda链受限浆细胞性骨髓瘤患者中，有13例在存在寡克隆模式的情况下，κ/λ比是κ占优势的。 κ限制的浆细胞骨髓瘤患者的κ/λ比值没有逆转。结论：ASCT与单纯化疗相比，寡克隆模式的发生率高得多。寡克隆模式的存在可能会干扰SPEP / SIFE的解释和确定完全缓解。最低限度地，寡克隆模式在15.5％的λ链受限浆细胞骨髓瘤患者中引起了错误的kappa显性κ/λ比。如果将类似的比率应用于167例kappa链骨髓瘤患者，则其中约26名将显示出错误的kappa链优势κ/λ比。寡克隆模式的存在进一步降低了已经令人怀疑的SFLCA的性能。强调了在SPEP / SIFE和更高分辨率的蛋白质电泳方法中记录单克隆刺突位置的需求.J Clin Med Res。 2017; 9（8）：671-679doi：https：//doi.org/10.14740/jocmr3049w

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