Significance of abnormal protein bands in patients with multiple myeloma following autologous stem cell transplantation

Hall, S. L., Tate, J., Gill, D. and Mollee, P. (2009) Significance of abnormal protein bands in patients with multiple myeloma following autologous stem cell transplantation. Clinical Biochemist Reviews, 30 3: 113-118.

Author Hall, S. L.
Tate, J.
Gill, D.
Mollee, P.
Title Significance of abnormal protein bands in patients with multiple myeloma following autologous stem cell transplantation
Journal name Clinical Biochemist Reviews   Check publisher's open access policy
ISSN 0159-8090
Publication date 2009-01-01
Year available 2009
Sub-type Critical review of research, literature review, critical commentary
Volume 30
Issue 3
Start page 113
End page 118
Total pages 6
Place of publication Australia
Publisher Australasian Association of Clinical Biochemists
Collection year 2010
Language eng
Subject 970111 Expanding Knowledge in the Medical and Health Sciences
111201 Cancer Cell Biology
Abstract Aim: We studied the characteristics of small abnormal protein bands (APB) (including oligoclonal bands and new apparent monoclonal bands) that are frequently detected by serum protein electrophoresis (SPEP) and isoelectric focusing (IEF) in the post-autologous stem cell transplant setting. Methods: In a retrospective analysis of patients with multiple myeloma undergoing transplantation, paraprotein identity and quantification were performed using standard immunofixation electrophoresis. The nature of any new bands was determined by IEF which distinguished between oligoclonal bands and apparent monoclonal bands. Results: Of 49 myeloma cases, the median follow-up was 33.7 months (range, 5.6-97.5 months) and 24 patients had relapsed. Thirty six (73%) developed APB. 22 patients had more than one episode of APB and 6 patients had more than 2 episodes resulting in a total of 69 episodes of APB observed post-transplant. IEF demonstrated 54 of these APB were oligoclonal bands and 15 appeared to be monoclonal. Of the 15 episodes of apparent monoclonal bands, 10 had differing heavy or light chain restriction compared to the original myeloma paraprotein and 5 had the same heavy and light chain restriction but different band location in the SPEP lane. Ten of these apparent monoclonal bands resolved, 5 persisted, and only one represented true disease progression. The presence of APB impacted favourably on event-free survival (p=0.05). Conclusion: Small APB are very frequent post-transplant for myeloma, and IEF can identify these APB as oligoclonal or monoclonal. Apparent monoclonal bands may represent relapsed disease, but in the vast majority of cases it does not, and most likely represents a transient phenomenon representing regeneration of a limited immune response.
Keyword Abnormal protein bands
Multiple myeloma
Stem cell transplantation
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
 
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Created: Wed, 21 Apr 2010, 19:54:42 EST by Maree Knight on behalf of Medicine - Princess Alexandra Hospital