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Detection and prevalence of monoclonal gammopathy of undetermined significance: a study utilizing mass spectrometry-based monoclonal immunoglobulin rapid accurate mass measurement
Journal article   Open access   Peer reviewed

Detection and prevalence of monoclonal gammopathy of undetermined significance: a study utilizing mass spectrometry-based monoclonal immunoglobulin rapid accurate mass measurement

David Murray, Shaji K Kumar, Robert A Kyle, Angela Dispenzieri, Surendra Dasari, Dirk R Larson, Celine Vachon, James R Cerhan and S Vincent Rajkumar
Blood cancer journal (New York), Vol.9(12), pp.102-7
12/13/2019
DOI: 10.1038/s41408-019-0263-z
PMCID: PMC6910906
PMID: 31836698
url
https://doi.org/10.1038/s41408-019-0263-zView
Published (Version of record) Open Access

Abstract

High-sensitivity mass spectrometry assays are available to detect monoclonal immunoglobulins. To better assess the prevalence of monoclonal gammopathy of undetermined significance (MGUS), we identified 300 patients diagnosed with MGUS or related gammopathy who had a prior negative work-up for monoclonal proteins as part of the Olmsted County MGUS screening study. Two mass spectrometry-based detection methods (matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and monoclonal immunoglobulin rapid accurate mass measurements (miRAMM) along with traditional immunofixation were performed on the Olmsted baseline and MGUS diagnostics serum samples. Among the 226 patients considered negative for MGUS based on protein electrophoresis and serum-free light-chain assay, a monoclonal protein could be detected at baseline in 24 patients (10.6%) by immunofixation, 113 patients (50%) by MADLI-TOF mass spectrometry, and 149 patients (65.9%) by miRAMM mass spectrometry. In addition, using miRAMM, some patients demonstrated an oligoclonal to monoclonal transition giving insight into the origin of MGUS. Using the sensitive miRAMM, MGUS is present in 887 of 17,367 persons from the Olmsted County cohort, translating into a prevalence of 5.1% among persons 50 years of age and older. This represents the most accurate prevalence estimate of MGUS thus far.
Adolescent Aged Aged, 80 and over Biomarkers, Tumor Child Child, Preschool Diagnosis, Differential Female Humans Immunoglobulin Light Chains Infant Male Mass Spectrometry - methods Middle Aged Monoclonal Gammopathy of Undetermined Significance - blood Monoclonal Gammopathy of Undetermined Significance - diagnosis Monoclonal Gammopathy of Undetermined Significance - epidemiology Myeloma Proteins Paraproteinemias - diagnosis Prevalence Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

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