TY - JOUR
T1 - MASS-FIX for the detection of monoclonal proteins and light chain N-glycosylation in routine clinical practice
T2 - a cross-sectional study of 6315 patients
AU - Mellors, Patrick W.
AU - Dasari, Surendra
AU - Kohlhagen, Mindy C.
AU - Kourelis, Taxiarchis
AU - Go, Ronald S.
AU - Muchtar, Eli
AU - Gertz, Morie A.
AU - Kumar, Shaji K.
AU - Buadi, Francis K.
AU - Willrich, Maria A.V.
AU - Lust, John A.
AU - Kapoor, Prashant
AU - Lacy, Martha Q.
AU - Dingli, David
AU - Hwa, Yi
AU - Fonder, Amie
AU - Hobbs, Miriam
AU - Hayman, Susan
AU - Warsame, Rahma
AU - Leung, Nelson R.
AU - Lin, Yi
AU - Gonsalves, Wilson
AU - Siddiqui, Mustaqeem
AU - Kyle, Robert A.
AU - Rajkumar, S. Vincent
AU - Murray, David L.
AU - Dispenzieri, Angela
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85102177106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102177106&partnerID=8YFLogxK
U2 - 10.1038/s41408-021-00444-0
DO - 10.1038/s41408-021-00444-0
M3 - Article
C2 - 33664227
AN - SCOPUS:85102177106
SN - 2044-5385
VL - 11
JO - Blood cancer journal
JF - Blood cancer journal
IS - 3
M1 - 50
ER -