Naslov
Therapeutic monoclonal antibody interference in electrophoretic and immunofixation techniques

Autori
Šahinović, Ines ; Sinčić-Petričević, Jasminka ; Oršić-Frič, Vlasta ; Borzan, Vladimir ; Pavela, Jasna ; Fijačko, Mirjana ; Šerić, Vatroslav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Clinica Chimica Acta, Special Issue, EuroMedLab2019, Volumen493 / - : Elsevier, 2019, 1-784

Skup
23rd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory Medicine (EUROMEDLAB 2019)

Mjesto i datum
Barcelona, Španjolska, 19.05.2019. - 23.05.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Therapeutic monoclonal antibody ; interference ; electrophoresis ; immunofixation

Sažetak
Background-aim Therapeutic monoclonal antibodies (t-mAb) have rapidly become a clinically important drug class because of their immunomodulatory effects. Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are ordered for a number of indications, including immunodeficiences, autoimmune and infectious diseases, for which treatment with a t-mAb is becoming common. These laboratory tests are also important in diagnostic work-up of patients with suspected plasma cell dyscrasias. Majority of t-mAb are of IgG kappa isotype, what raises a concern whether a t-mAb, if not properly identified, could be misinterpreted on SPE or IFE. The aim of our study was to determine if t-mAbs infliximab, adalimumab, vedolizumab and rituximab interfere with SPE or IFE. Methods Serum samples from four patients undergoing therapy with infliximab (IFX), adalimumab (ADA), vedolizumab (VEDO) and rituximab (RITU) were used. Two samples of venous blood were collected for each patient at peak (a day after drug administration-IFX, ADA and VEDO and after a drug administration on day 5 of therapy protocol-RITU) and at trough (a day before next dose administration). SPE analysis was performed using Sebia Minicap capillary electrophoresis (Sebia, USA) and IFE using Sebia Hydrasys (Sebia, USA). Results SPE and IFE findings show no abnormalities for IFX and ADA at peak concentration. No abnormalities were identified on SPE nor IFE for any of the t- mAb at trough concentration. On SPE only for rituximab a band was visible at the cathodal end of the gamma fraction. On IFE monoclonal bands identified as IgG kappa were noted for VEDO and RITU. VEDO migrated closer to the middle of the gamma fraction, although not as a clear sharp band. RITU migrated to the far cathodal end of gamma fraction. Conclusions Our results show that awareness of the presence of monoclonal protein by SPE/IFE following recent VEDO or RITU administration is important to avoid clinical misinterpretation and unnecessary further evaluation for pathologic monoclonal gammapathy. When SPE and IFE are performed within a couple of days from infusion, especially for VEDO and RITU, t-mAb can appear as a monoclonal protein. SPE/IFU should be conducted a day prior to the drug administration in order to avoid misinterpretation.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

POVEZANOST RADA