[Studying daratumumab's interference in serum protein electrophoresis: two case reports]
Alexandre Leonard1, Benjamin Bonnet2, Carolyne Croizier3
1Service de Biochimie et Génétique Moléculaire, CHU Clermont-Ferrand, F-63000, Clermont-Ferrand, France.
An 86-year-old woman is monitored for IgA λ-associated multiple myeloma, treated in second intention with dexamethasone, revlimid and daratumumab after a relapse. A control serum protein electrophoresis detects the presence of a new monoclonal spike, later confirmed by immunofixation as an IgG κ. Suspecting an interference due to the immunotherapy, a daratumumab specific immunofixation reflex assay (DIRA) is performed, with the addition of anti-daratumumab antibodies, confirming the interference. A second multiple myeloma case is presented, describing interference with daratumumab co-migrating with the original monoclonal immunoglobulin. Based on these cases, we propose an algorithm of action to confirm the interference and provide an accurate biological result consistent with the therapeutic and clinical context.
An 86-year-old woman is monitored for IgA λ-associated multiple myeloma, treated in second intention with dexamethasone, revlimid and daratumumab after a relapse. A control serum protein electrophoresis detects the presence of a new monoclonal spike, later confirmed by immunofixation as an IgG κ. Suspecting an interference due to the immunotherapy, a daratumumab specific immunofixation reflex assay (DIRA) is performed, with the addition of anti-daratumumab antibodies, confirming the interference. A second multiple myeloma case is presented, describing interference with daratumumab co-migrating with the original monoclonal immunoglobulin. Based on these cases, we propose an algorithm of action to confirm the interference and provide an accurate biological result consistent with the therapeutic and clinical context.
More Related Videos
07:25In Vitro Methods for Comparing Target Binding and CDC Induction Between Therapeutic Antibodies: Applications in Biosimilarity Analysis
Published on: May 4, 2017
11:02Genetic Encoding of a Non-Canonical Amino Acid for the Generation of Antibody-Drug Conjugates Through a Fast Bioorthogonal Reaction
Published on: September 14, 2018
