Using MALDI-TOF mass spectrometry in peripheral blood for the follow up of newly diagnosed multiple myeloma patients treated with daratumumab-based combination therapy

Marion Eveillard, Neha Korde, Amanda Ciardiello, Benjamin Diamond, Alexander Lesokhin, Sham Mailankody, Eric Smith, Hani Hassoun, Malin Hultcrantz, Urvi Shah, Sydney Lu, Meghan Salcedo, Kelly Werner, Jenna Rispoli, Donna Mastey, Ola Landgren, Katie Thoren

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Daratumumab-based combination therapies have shown high rates of complete response (CR) and minimal residual disease negativity in patients with multiple myeloma. However, daratumumab, an IgGκ monoclonal antibody, interferes with electrophoretic techniques making it difficult to reliably define residual disease versus CR, especially in patients with IgGκ multiple myeloma. Methods: Enrichment with polyclonal sheep antibody-coated magnetic microparticles combined with MALDI-TOF mass spectrometry (MALDI-TOF MS) analysis was used to detect M−proteins in serial samples from newly diagnosed multiple myeloma patients treated with daratumumab-based therapy. The performance of the MALDI-TOF MS assay was compared to that of a routine test panel (serum protein electrophoresis (SPEP), immunofixation (IFE) and serum free light chain (FLC)). Results: Comparison of MALDI-TOF MS to SPEP/IFE/FLC showed a concordance of 84.9% (p < 0.001). When MALDI-TOF MS and FLC results were combined, the M−protein detection rate was the same or better than the routine test panel. For the 9 patients who obtained CR during follow-up, MALDI-TOF MS detected an M−protein in 46% of subsequent samples. Daratumumab could be distinguished from the M−protein in 215/222 samples. Conclusion: MALDI-TOF MS is useful in assessing CR in patients treated with monoclonal antibody-based therapies.

Original languageEnglish (US)
Pages (from-to)136-141
Number of pages6
JournalClinica Chimica Acta
Volume516
DOIs
StatePublished - May 2021
Externally publishedYes

Keywords

  • Daratumumab
  • Immunofixation
  • MALDI-TOF mass spectrometry
  • Multiple myeloma
  • M−protein

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Biochemistry, medical

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