<p>Analysis of M-components is an important part of the diagnosis of monoclonal gammopathies and for the evaluation of disease response during treatment. In this project, two widely used electrophoresis methods and their corresponding immunotyping method were compared to evaluate the sensitivity of each method for the detection of small M-components. The project included 30 plasma samples from patients with identified M-components; 10 samples containing each IgG, IgA and IgM, respectively. All samples were diluted with normal EDTA plasma to achieve M-components of 5,00g/L. The samples were then serially diluted to achieve M-component concentrations of; 5,00, 2,50, 1,25, 0,63, 0,31 and 0,16g/L. All 180 samples were analysed with agarose gel electrophoresis and capillary electrophoresis. The dilutions above and below the detection level of each method were then analysed with immunofixation and immunosubtraction. The results showed good agreement between agarose gel electrophoresis and capillary electrophoresis in the highest concentrations of IgG and IgM. With agarose gel electrophoresis, IgA was detected in the same location as transferrin and the lowest concentration detected were therefore 1,25g/L. Besides the samples containing IgG, immunofixation was the most sensitive method.</p>

Analysis of M-components is an important part of the diagnosis of monoclonal gammopathies and for the evaluation of disease response during treatment. In this project, two widely used electrophoresis methods and their corresponding immunotyping method were compared to evaluate the sensitivity of each method for the detection of small M-components. The project included 30 plasma samples from patients with identified M-components; 10 samples containing each IgG, IgA and IgM, respectively. All samples were diluted with normal EDTA plasma to achieve M-components of 5,00g/L. The samples were then serially diluted to achieve M-component concentrations of; 5,00, 2,50, 1,25, 0,63, 0,31 and 0,16g/L. All 180 samples were analysed with agarose gel electrophoresis and capillary electrophoresis. The dilutions above and below the detection level of each method were then analysed with immunofixation and immunosubtraction. The results showed good agreement between agarose gel electrophoresis and capillary electrophoresis in the highest concentrations of IgG and IgM. With agarose gel electrophoresis, IgA was detected in the same location as transferrin and the lowest concentration detected were therefore 1,25g/L. Besides the samples containing IgG, immunofixation was the most sensitive method.

Light Chain Deposition Disease (LCDD) is a type of monoclonal immunoglobulin deposition disease characterized by the non-amyloid deposition of monoclonal light chains in the tubular basement membranes and Bowman’s capsule. It was first described about 3 decades ago, but due to varied clinical presentations, many differential diagnoses and low incidence, it is both underrecognized and underreported. We present a case of 85-year-old female with past medical history significant for CKD and HTN, who presented with accelerated HTN, normocytic anemia and worsening renal function. Laboratory data showed Hgb <9.5 gm/dL, MCV 93 fL, Total protein 5.9, Albumin 3.2, Calcium 8.9, Serum Creatinine 2.37, BUN 45, Urine with hematuria (50–99 erythrocytes per high-power field) and nephrotic range proteinuria. Renal biopsy showed evidence of Membranoproliferative glomerulonephritis, with immunofluorescence features indicative of a monoclonal immunoglobulin deposition disease. Bone marrow biopsy showed mildly increased plasma cells (5-7%) confirmed to be clonal (lambda light chain) by flow cytometry, negative for Congo-Red stain. Although no underlying hematological abnormality like Multiple Myeloma or Amyloidosis was observed in this case, the renal pathological findings is consistent with proliferative glomerulonephritis with monoclonal IgG lambda deposits. There is no standard of care for the management of LCDD based on rarity of this condition. Many treatment modalities including chemotherapy and stem cell transplant have been tried. A combination of high dose melphalan or Cyclophosphamide with dexamethasone is preferred for Non-IgM type monoclonal protein kidney deposition, like in this case. Bortezomib and Thalidomide-based chemotherapy have been promising in recent research. For IgM type monoclonal protein deposition, Rituximab alone or in combination with cyclophosphamide and dexamethasone are used. This patient was not a good candidate for corticosteroid and chemotherapy or stem cell transplant due to old age (>77 years) and poor functional status, therefore, was started on hemodialysis. Following dialysis, improvement in renal function and general clinical condition was evident. The prognostic factors include age, degree of renal insufficiency at presentation affecting the renal prognosis, underlying hematologic disorder and extrarenal LC deposition. In this case, despite hemodialysis, long term survival and prognosis remain poor due to her inability to tolerate chemotherapy.

Multiple myeloma is an incurable fatal neoplasm of plasma cells affecting mainly elderly people. There are many research laboratories in the world where multiple myeloma is studied. Permanent cell lines are indispensable tools for both basic and applied research. However, the establishment of new cell lines is difficult with poor success. We established 96 primary cultures of bone marrow samples from myeloma patients. Only one culture succeeded in permanet myeloma cell line. The novel plasmacytic cell line ÚHKT-893 was established from bone marrow sample of 57 years old female relapsed with multiple myeloma of IgGκ isotype. The cell line is however dependent on the continuous presence of interleukin-6 in culture media. ÚHKT-893 cells grow continuously already more than 1 year. The growth of cells was regularly monitored according to growth curves and by measurement of cell viability. Surface antigenic profile was repeatedly determined by flow cytometry. The simultaneous expression of both CD138 and CD38 surface molecules confirmed the plasma cell origin of cells. The establishment of the ÚHKT-893 myeloma cell line will extend the panel of existing myeloma cell lines as a new ex vivo model for the study of the etiology and pathogenesis of multiple myeloma. It will also provide the source of new...