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Updated: Jul 26, 2026
Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Electrophoretic patterns post daratumumab
Joanna Sheldon1, Rachel D Wheeler1, Ray Powles2
11 Protein Reference Unit, 443664 South West London Pathology, St. George's Hospital , London, UK.
Insights
Daratumumab (Darzalex), a CD38 monoclonal antibody for multiple myeloma, appears as a small band on serum protein electrophoresis. This finding requires careful interpretation to avoid misdiagnosis of new monoclonal protein development.
Area of Science:
- Clinical Chemistry
- Hematology
- Immunology
Background:
- Daratumumab (Darzalex) is an IgG1 kappa monoclonal antibody targeting CD38.
- It is approved for treating refractory multiple myeloma.
- As a monoclonal protein, it is detectable via serum protein electrophoresis (SPEP) and immunofixation (SIF).
Purpose of the Study:
- To investigate the detectability of daratumumab on routine serum protein electrophoresis.
- To inform diagnostic laboratories about potential misinterpretations of daratumumab as a new monoclonal protein.
Main Methods:
- Serum samples from four multiple myeloma patients were analyzed.
- Electrophoresis was performed immediately before and after daratumumab treatment.
Main Results:
- Daratumumab was consistently visible on SPEP as a distinct, small band.
- The band appeared in the slow gamma region, approximately 1 g/L.
Conclusions:
- Daratumumab is detectable on routine serum protein electrophoresis in multiple myeloma patients.
- Diagnostic laboratories must be aware of this finding to prevent misdiagnosis.
- Close collaboration between laboratories and clinicians is crucial for accurate interpretation.
Abstract:
Background Daratumumab (Darzalex) is a human IgG1 kappa monoclonal antibody targeting CD38 that has been recently approved for the treatment of refractory multiple myeloma. As it is a monoclonal protein, it can be detected on routine serum protein electrophoresis and by immunofixation. Methods Serum samples from four patients were analysed by serum protein electrophoresis immediately pre- and post-treatment with daratumumab. Results For all four patients, daratumumab was visible on serum protein electrophoresis as an additional small band (approximately 1 g/L) in the slow gamma region. Conclusion Diagnostic laboratories should be aware that daratumumab can be detected on routine serum protein electrophoresis of myeloma patients and should liaise closely with clinicians to ensure the presence of daratumumab is not misinterpreted as development of a new monoclonal protein.
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