Classification and differential diagnosis of monoclonal gamma myopathy are based on clinical, biologic, and radiologic standards but is still difficult in some cases. Multiple myeloma (MM) is the most common malignant gamma mastopathy with a wide repertoire of signs and symptoms.

Over the past 10 years, treatment options for patients with MM have expanded significantly. Along with improvements in supportive care, these new therapies significantly prolong survival in young and older patients. However, if multiple myeloma is suspected, several procedures ensure the diagnosis; the most important tests include:

• Blood and urine tests. They are examined for the presence of a specific protein (paraprotein) produced by malignantly growing plasma cells.
• Imaging procedures such as computed tomography (CT) and magnetic resonance imaging (MRI).
• Examination of bone marrow samples from the iliac crest (tumor biopsy).

What is one of the most important tests for multiple myeloma?

To clarify the diagnosis of multiple myeloma, doctors measure laboratory values of blood and urine. Determination of these values is also necessary during the course of the disease to control its evolution. In addition to measuring the number of red blood cells, white blood cells, and platelets and various urine tests, so-called protein electrophoresis plays a key role.

Protein electrophoresis is a laboratory medical technique in which proteins from a sample, in this case blood, are separated so that the doctor can see how much different proteins are in that sample. This test is very important because it can determine the amount of paraprotein (M-protein). This is also called determining the gradient M. With this analysis two things can be established:

• Paraprotein (M-protein) level: In multiple myeloma, too much of the protein paraprotein (also called β2M protein) is produced. Protein electrophoresis can be used to determine the amount of β2M in the blood.
• Detection of free light chains in serum: This test is important in diagnosing a specific type of multiple myeloma in which no paraprotein can be detected.

What is blood protein electrophoresis?

Protein electrophoresis is a laboratory medical technique in which blood proteins are separated so that the doctor can see how much the individual proteins are in the blood. The principle works similarly to the decomposition of a spot color into its individual colors in a chromatographic separation: if you apply a spot color on a filter paper and drip a solvent on it, the individual color particles migrate to the outside to a different extent depending on their size, weight, and interaction with the paper and solvent.

In electrophoresis, the blood serum is applied to a circulating medium, such as a filter, film, or gel. Then, with the help of electrodes, a potential difference is applied along the operating medium. Depending on their size, weight, and electrical charge, protein particles travel along the moving medium to varying degrees. This creates a very typical pattern. This pattern is converted by computers, so the doctor receives a clear curve diagram, in which you usually see five curves, which correspond to the five predominant proteins in the blood:

• Albumin is a protein in the blood that can carry various substances, such as hormones or fats, through the blood. Total blood protein consists of approximately 60 percent albumin.
• Alpha-1, alpha-2, and beta globulins: These are proteins that serve as transporters for a variety of substances in the blood, such as fats or vitamins.
• Immunoglobulins, which are mostly gamma globulins. Immunoglobulins (so-called “antibodies”) are proteins that fight pathogens.

Other proteins that are the basis of the diagnosis of MM and stage of disease may also appear. Depending on the stage, doctors can estimate how advanced the disease is. Treatment and prognosis depend on it. The disease is divided into stages I to III. Classification is based on the amount of two types of proteins in the blood. They are β-2-microglobulin (β2M) and albumin, levels of which are determined by blood tests. The higher the β2M level in the blood, the more advanced the stage of multiple myeloma.

Why choose Kalstein horizontal electrophoresis equipment?

As described in this article, the determination of a certain group of proteins in the blood is critical for the diagnosis of MM, its stage and its treatment. For this reason, having horizontal electrophoresis equipment from the manufacturer Kalstein in a bioanalysis laboratory is essential. With this equipment you can control the separation temperature, has a rod that allows you to adjust the length according to the path of the analytes and comes with deployed electrodes that facilitate its use. For more technical details, prices, purchase and quotation you can check the page HERE