Myeloma, Minimal Residual Protein Detection Panel

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General Information

Lab Name
Myeloma, Minimal Residual Protein Detection Panel
Lab Code
ELPMCP
Epic Ordering
Myeloma, Minimal Residual Protein Detection Panel
Description

The primary purpose of this test is to detect minimal residual disease in a patient with a known monoclonal protein or to establish a UW laboratory diagnosis of a known M-spike.

This test may also be useful for amyloidosis screening. The International Myeloma Working Group recommends that screening for AL amyloidosis include the following tests: serum protein electrophoresis, serum and urine immunofixation, and serum free light chains (FLC) (Dispenzieri et al, Leukemia (2009) 23:215. https://pubmed.ncbi.nlm.nih.gov/19020545/).

The initial test performed is serum protein electrophoresis. Samples with a monoclonal band present on protein electrophoresis that has previously been identified in this laboratory will be resulted with the concentration of the known M-spike, without further testing. Samples demonstrating previously unidentified protein bands of concern will be tested by immunofixation. If a monoclonal band is identified by immunofixation, its concentration will be reported.

If no monoclonal band is identified by protein electrophoresis, an immunofixation test will automatically be performed. If no monoclonal band is identified by electrophoresis or immunofixation, the specimen will be reflexively tested for serum free light chain concentrations (FLC). All reflexive tests will generate additional results and charges.

Synonyms
Amyloid, Amyloidosis, Multiple myeloma, Myeloma, Waldenstrom
Components

Interpretation

Method

Agarose Electrophoresis (Sebia system)

Reference Range
See individual components
Interferences and Limitations

Hemolysis may falsely elevate alpha-2 and beta components.
Stability: 1 week refrigerated; stable long-term if frozen.

Guidelines

Ordering & Collection

Specimen Type
Serum
Collection

5 mL blood in RED TOP or GOLD SST Tube

Handling Instructions
Quantity
requested: 1.5 mL serum
minimum: 1.5 mL serum

Processing

Processing

Refrigerate serum.
Make two aliquots: 1.0 mL to IMM for ELP and 0.5 mL to CHEM for ETP

Performance

LIS Dept Code
Immunology (IMM)
Performing Location(s)
UW-MT Immunology
206-520-4600

Clinical Lab, Room NW220,
University of Washington Medical Center,
1959 NE Pacific street, Seattle, WA 98195
Frequency
Monday - Friday
Available STAT?
No

Billing & Coding

CPT codes
84165x2
LOINC
33358-3