MASS-FIX for the detection of monoclonal proteins and light chain N-glycosylation in routine clinical practice: a cross-sectional study of 6315 patients

Patrick W. Mellors, Surendra Dasari, Mindy C. Kohlhagen, Taxiarchis Kourelis, Ronald S. Go, Eli Muchtar, Morie A. Gertz, Shaji K. Kumar, Francis K. Buadi, Maria A.V. Willrich, John A. Lust, Prashant Kapoor, Martha Q. Lacy, David Dingli, Yi Hwa, Amie Fonder, Miriam Hobbs, Susan Hayman, Rahma Warsame, Nelson R. LeungYi Lin, Wilson Gonsalves, Mustaqeem Siddiqui, Robert A. Kyle, S. Vincent Rajkumar, David L. Murray, Angela Dispenzieri

Research output: Contribution to journalArticlepeer-review

Abstract

Immunoenrichment-based matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), termed MASS-FIX, offers several advantages over immunofixation for the detection and isotyping of serum monoclonal protein, including superior sensitivity and specificity, the ability to differentiate therapeutic monoclonal antibodies, and the rapid identification of light chain (LC) N-glycosylation. We identified 6315 patients with MASS-FIX performed at our institution since 2018. Of these, 4118 patients (65%) with a wide array of plasma cell disorders (PCD), including rare monoclonal gammopathies of clinical significance, had a positive MASS-FIX. Two-hundred twenty-one (5%) of the MASS-FIX positive patients had evidence of LC N-glycosylation, which was more commonly identified in IgM heavy chain isotype, kappa LC isotype, and in diagnoses of immunoglobulin light chain (AL) amyloidosis and cold agglutinin disease (CAD) compared to other PCD. This cross-sectional study describes the largest cohort of patients to undergo MASS-FIX in routine clinical practice. Our findings demonstrate the widespread utility of this assay, and confirm that LC N-glycosylation should prompt suspicion for AL amyloidosis and CAD in the appropriate clinical context.

Original languageEnglish (US)
Article number50
JournalBlood cancer journal
Volume11
Issue number3
DOIs
StatePublished - Mar 2021

ASJC Scopus subject areas

  • Hematology
  • Oncology

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