Using MALDI-TOF mass spectrometry in peripheral blood for the follow up of newly diagnosed multiple myeloma patients treated with daratumumab-based combination therapy

•The highest M−protein detection rates occur with MALDI-TOF MS plus FLC measurement.•MALDI-TOF MS can help accurately determine complete response status in patients.•Daratumumab can be distinguished from the M−protein in most samples by MALDI-TOF MS.•Relative concentration and mass difference matter...

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Bibliographic Details
Published in:Clinica chimica acta 2021-05, Vol.516, p.136-141
Main Authors: Eveillard, Marion, Korde, Neha, Ciardiello, Amanda, Diamond, Benjamin, Lesokhin, Alexander, Mailankody, Sham, Smith, Eric, Hassoun, Hani, Hultcrantz, Malin, Shah, Urvi, Lu, Sydney, Salcedo, Meghan, Werner, Kelly, Rispoli, Jenna, Mastey, Donna, Landgren, Ola, Thoren, Katie
Format: Article
Language:English
Subjects:
Animals
Antibodies, Monoclonal
Daratumumab
Follow-Up Studies
Humans
Immunofixation
MALDI-TOF mass spectrometry
Multiple myeloma
Multiple Myeloma - diagnosis
Multiple Myeloma - drug therapy
M−protein
Sheep
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
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Summary:•The highest M−protein detection rates occur with MALDI-TOF MS plus FLC measurement.•MALDI-TOF MS can help accurately determine complete response status in patients.•Daratumumab can be distinguished from the M−protein in most samples by MALDI-TOF MS.•Relative concentration and mass difference matters for distinguishing proteins. Daratumumab-based combination therapies have shown high rates of complete response (CR) and minimal residual disease negativity in patients with multiple myeloma. However, daratumumab, an IgGκ monoclonal antibody, interferes with electrophoretic techniques making it difficult to reliably define residual disease versus CR, especially in patients with IgGκ multiple myeloma. Enrichment with polyclonal sheep antibody-coated magnetic microparticles combined with MALDI-TOF mass spectrometry (MALDI-TOF MS) analysis was used to detect M−proteins in serial samples from newly diagnosed multiple myeloma patients treated with daratumumab-based therapy. The performance of the MALDI-TOF MS assay was compared to that of a routine test panel (serum protein electrophoresis (SPEP), immunofixation (IFE) and serum free light chain (FLC)). Comparison of MALDI-TOF MS to SPEP/IFE/FLC showed a concordance of 84.9% (p 
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2021.01.021