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 Kumar,Francis K. Buadi,Maria Alice V. Willrich,John A. Lust,Prashant Kapoor,Martha Q. Lacy,David Dingli,Yi Hwa,Amie Fonder,Miriam Hobbs,Susan R. Hayman,Rahma Warsame,Nelson Leung,Yi Lin,Wilson I. Gonsalves,Mustaqeem A. Siddiqui,Robert A. Kyle,S. Vincent Rajkumar,David L. Murray,Angela Dispenzieri +26 more
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TLDR
In this paper, the authors performed mass spectrometric analysis of patients with a wide array of plasma cell disorders (PCD), including rare monoclonal gammopathies of clinical significance, and found that two hundred twenty-one (5%) of the positive patients had evidence of light chain N-glycosylation.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.read more
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Transient disorder along pathways to amyloid
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Transient disorder along pathways to amyloid
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Role of mutations and post-translational modifications in systemic AL amyloidosis studied by cryo-EM
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TL;DR: In this paper , the analytical performance of a new mass spectrometry-based method, termed MASS-FIX, when screening for plasma cell disorders in a routine clinical laboratory was examined for consistency with pretest implementation performance.
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TL;DR: Exent&FLC-MS is more sensitive than IFE in detecting the M-protein of MM patients in serum, both at baseline and during treatment monitoring, and is more accurate to predict patients’ outcome.
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Comprehensive Assessment of M-Proteins Using Nanobody Enrichment Coupled to MALDI-TOF Mass Spectrometry.
John Mills,Mindy C. Kohlhagen,Surendra Dasari,Patrick M. Vanderboom,Robert A. Kyle,Jerry A. Katzmann,Maria Alice V. Willrich,David R. Barnidge,Angela Dispenzieri,David L. Murray +9 more
TL;DR: In this paper, a mass spectrometry-based method called MASS-FIX was proposed to identify and quantify monoclonal proteins (M-proteins) encountered clinically.