利用质谱法清除骨髓瘤治疗中的药物干扰。
Clearing drug interferences in myeloma treatment using mass spectrometry.
机构信息
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
出版信息
Clin Biochem. 2021 Jun;92:61-66. doi: 10.1016/j.clinbiochem.2021.02.011. Epub 2021 Mar 7.
OBJECTIVE
To explore the possibility of using a combination of a rapid MALDI-TOF-MS method (Mass-Fix) in conjunction with higher resolution LC-ESI-QTOF-MS (miRAMM) measurements to discriminate the IgG kappa M-protein from daratumumab, elotuzumab and isatuximab in myeloma patients.
DESIGN & METHODS: 86 patients with an IgG kappa M-protein were spiked with therapeutic levels of the drugs and examined by Mass-Fix and miRAMM to establish the percent of cases that could be resolved by each method. The method was then applied to 21 samples from patients receiving one of the drugs.
RESULTS
Mass-Fix was capable of resolving the t-mAb from M-protein for 87 percent of the spiked samples. For the cases unresolved by Mass-Fix, miRAMM was capable of resolving the remaining drug interferences. The 21 IgG kappa myeloma patients that were receiving the drugs were all resolved by Mass-Fix.
CONCLUSION
This proposed algorithm allows use of a clinical available assay (Mass-Fix) while maximizing the number of cases that can accurately resolve the t-mAb from the M-protein.
目的
探索联合使用快速 MALDI-TOF-MS 方法（Mass-Fix）和更高分辨率的 LC-ESI-QTOF-MS（miRAMM）测量来区分多发性骨髓瘤患者的 IgG κ M 蛋白与达雷妥尤单抗、依洛珠单抗和伊沙妥珠单抗。
设计与方法
在 86 例 IgG κ M 蛋白患者中加入治疗水平的药物，通过 Mass-Fix 和 miRAMM 进行检测，以确定每种方法可解决的病例百分比。然后将该方法应用于接受其中一种药物的 21 例患者样本。
结果
Mass-Fix 能够解决 87%加标样本中 t-mAb 与 M 蛋白的问题。对于 Mass-Fix 无法解决的情况，miRAMM 能够解决剩余的药物干扰。正在接受这些药物治疗的 21 例 IgG κ 多发性骨髓瘤患者均通过 Mass-Fix 得到解决。
结论
该算法允许使用临床可用的检测方法（Mass-Fix），同时最大限度地提高能够准确区分 t-mAb 与 M 蛋白的病例数量。
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