治疗性单克隆抗体对多发性骨髓瘤患者常规血清蛋白电泳和免疫固定的干扰：达妥木单抗和埃罗妥珠单抗的检测频率和持续时间。
Interference of Therapeutic Monoclonal Antibodies With Routine Serum Protein Electrophoresis and Immunofixation in Patients With Myeloma: Frequency and Duration of Detection of Daratumumab and Elotuzumab.
机构信息
School of Medicine, Case Western Reserve University, Cleveland, OH.
Department of Hematology/Oncology, University Hospitals of Cleveland Medical Center, Cleveland, OH.
出版信息
Am J Clin Pathol. 2018 Jul 3;150(2):121-129. doi: 10.1093/ajcp/aqy037.
OBJECTIVES
We investigated the frequency and pattern of detection of therapeutic monoclonal antibodies (t-mAbs) daratumumab and elotuzumab by routine serum protein electrophoresis (SPE) and immunofixation (IF) in treated patients with myeloma.
METHODS
Detection of t-mAb was assessed in 22 patients by retrospective review of SPE/IF ordered prior to, during, and after 26 individual courses of therapy.
RESULTS
t-mAb was distinguishable from M-protein in 16 of 26 courses, with daratumumab detected in nine of nine and elotuzumab in six of seven patients. t-mAb was detected on first follow-up SPE/IF in 12 patients, with earliest detection 7 days after therapy initiation and latest detection 70 days after therapy. t-mAb persisted throughout induction therapy in most patients, with loss of detection during maintenance daratumumab.
CONCLUSIONS
When distinguishable from M-protein, t-mAbs are detectable in 93% of treated patients as soon as 7 days after the initial dose and are consistently observed throughout induction therapy, warranting increased monitoring and careful interpretation of SPE/IF.
目的
我们通过对骨髓瘤患者治疗前后的常规血清蛋白电泳（SPE）和免疫固定（IF）检测，研究了治疗性单克隆抗体（t-mAb）达雷妥尤单抗和埃罗妥珠单抗的检测频率和模式。
方法
通过回顾性分析 26 个疗程之前、期间和之后的 SPE/IF 检测，评估了 22 例患者中 t-mAb 的检测情况。
结果
在 26 个疗程中，有 16 个疗程可以区分 t-mAb 和 M 蛋白，其中达雷妥尤单抗在 9 个疗程中检测到，埃罗妥珠单抗在 7 个疗程中检测到。在 12 例患者的首次随访 SPE/IF 中检测到 t-mAb，最早在治疗开始后 7 天检测到，最晚在治疗后 70 天检测到。t-mAb 在大多数患者的诱导治疗期间持续存在，在达雷妥尤单抗维持治疗期间检测不到。
结论
当可以与 M 蛋白区分时，t-mAb 在初始剂量后最早 7 天就可以在 93%的治疗患者中检测到，并且在整个诱导治疗期间持续观察到，需要增加监测并仔细解释 SPE/IF。
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