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An

Immunofixation

Tutorial

Presented by

John OKeefe

Sha Robinson, PhD

Rita Ellerbrook, PhD

Jeff Spencer, PhD


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Bibliography

Alexanian R, Weber D, Liu F. 1999. Dierenal diagnosis of monoclonal gammopathies. Arch Pathol Lab Med 123:108-113.

Aaelmannan M, Levinson SS. 2000. Understanding and idenfying monoclonal gammopathies. Clin Chem 46(8[B]):1230-1238.

Cesana C, Klersy C, Barbarano L, Nosari AM, et al. 2002. Prognosc factors for malignant transformaon in monoclonal gammopathy of

undetermined signicance and smoldering mulple myeloma. J Clinical Oncol 20(6): 1625-1634.

Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, Miguel JS, Chanan-Khan A, Ludwig H, Joshua D, Mehta J, Gertz M, Avet-Loiseau H,

Beksac M, Anderson KC, Moreau P, Singhal S, Goldschmidt H, Boccadoro M, Kumar S, Giralt S, Munshi NC, Jagannath S. 2011. Consensusrecommendaons for standard invesgave workup: report of the Internaonal Myeloma Workshop Consensus Panel 3. Blood

117(18):4701-4705.

George ED, Sadovsky R. 1999. Mulple myeloma: recognion and management. Am Fam Physician 59(7):1885-1894.

Goeken JA, Keren DF. 1999. Introducon to the report of the consensus conference on monoclonal gammopathies. Arch Pathol Lab Med

123(2):104-105.

Gupta S, Comenzo RL, Homan BR, Fleisher M. Naonal Academy of Clinical Biochemistry guidelines for the use of tumor markers in

monoclonal gammopathies [Internet]. 2007 [cited 2011 Oct 7]. Available from hp://www.aacc.org/SiteColleconDocuments/NACB/

LMPG/tumor/chp3k_gammopathies.pdf

Keren DF. 1987. High-resoluon electrophoresis and immunoxaon: techniques and interpretaon. Boston (MA): Buerworths. 238 p.

Keren DF. 2003. Protein electrophoresis in clinical diagnosis. London (UK): Hodder Arnold. 416 p.

Keren DF, Alexanian R, Goeken JA, Gorevic PD, Kyle RA, Tomar RH. 1999. Guidelines for clinical and laboratory evaluaon of paents with

monoclonal gammopathies. Arch Pathol Lab Med 123(2):106-107.

Keren DF, Warren JS, Lowe JB. 1988. Strategy to diagnose monoclonal gammopathies in serum: high-resoluon electrophoresis,

immunoxaon, and kappa/lambda quancaon. Clin Chem 34(11):2196-2201.

Kyle RA. 1994. The monoclonal gammopathies. Clin Chem 40:2154-2161.

Kyle RA. 1999. Sequence of tesng for monoclonal gammopathies: serum and urine assays. Arch Pathol Lab Med 123(2):114-118.

Kyle RA, Remstein ED, Therneau TM, Dispenzieri A, Kurn PJ, Hodneeld JM, Larson DR, Plevak MF, Jelinek DF, Fonseca R, Melton III LJ,

Rajkumar SV. 2007. Clinical course and prognosis of smoldering (asymptomac) mulple myeloma. N Engl J Med 356:2582-2590.

Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Oord JR, Dispenzieri A, Katzmann JA, Melton III LJ. 2006. Prevalence of

monoclonal gammopathy of undetermined signicance. N Engl J Med 354:1362-1369.

Levinson SS, Keren DF. 1994. Free light chains of immunoglobulins: clinical laboratory analysis. Clin Chem 40(10): 1869-1878.

Lust JA, Donovan KA. 1998. Biology of the transion of monoclonal gammopathy of undetermined signicance (MGUS) to mulple

myeloma. Cancer Control 5(3):209-217.

Mark T, Jayabalan D, Coleman, M, Pearse RN, Wang YL, Lent R, Christos PJ, Lee JW, Agrawal YP, Mahew S, Ely S, Mazumdar M,

Cesarman E, Leonard JP, Furman RR, Chen-Kiang S, Niesvizky R. 2008. Atypical serum immunoxaon paerns frequently emerge in

immunomodulatory therapy and are associated with a high degree of response in mulple myeloma. Brit J Haematol 143:654660.

Naonal Cancer Instute [Internet]. Plasma cell neoplasms (including mulple myeloma) treatment. 2011 [cited 2011 Oct 7]. Available

from hp://www.cancer.gov/cancertopics/pdq/treatment/myeloma/healthprofessional

OConnell TX, Horita TJ, Kasravi B. 2005. Understanding and interpreng serum protein electrophoresis. Am Fam Physician 71(1):105-112.

Rajkumar SV. 2005. MGUS and smoldering mulple myeloma: update on pathogenesis, natural history, and management. Hematology

340-345.Sheldon J, Riches P. Paraproteins: a review arcle and MCQs. UK Myeloma Forum [Internet]. 2011 [cited 2011 Oct 7]. Available from

hp://www.ukmf.org.uk/paraproteins.htm

Su L, Keren DF, Warren JS. 1995. Failure of an-lambda immunoxaon reagent mimics alpha heavy-chain disease [Leer]. Clin Chem

41(1):121-123.

Vladuu AO. 1995. Immunoselecon vs immunoxaon for light chain typing [Leer]. Clin Chem 41(6):947-948.

Zent CS, Wilson CS, Tricot G. 1998. Oligoclonal protein bands and Ig isotype switching in mulple myeloma treated with high-dose

therapy and hematopoiec cell transplantaon. Blood 91(9):3518-3523.


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