High-resolution zone electrophoresis, combined with immunofixation, in the detection of an occult myeloma paraprotein.

A high-resolution agarose gel electrophoretic technique, coupled with immunofixation, was used to follow paraprotein concentrations retrospectively in a patient with multiple myeloma of nine years' duration. Although the patient's IgA lambda gammopathy "disappeared" shortly after the initiation of therapy, as judged by routine cellulose acetate electrophoresis and immunoelectrophoresis, high-resolution zone electrophoresis demonstrated a monoclonal band that we identified by immunofixation as the IgA lambda paraprotein. The combination of the two simple, inexpensive, and reliable techniques of high-resolution agarose electrophoresis and immunofixation thereby permitted detection and identification of a myeloma protein in a patient otherwise thought to be in complete remission. We believe this approach is useful in assessing persistent or recurrent disease in patients with a known history of myeloma; this combination of techniques may also prove beneficial in the early diagnosis of multiple myeloma.