9/2/2023 0 Comments Spep alfa 2 m spike meaning![]() ![]() These studies have recognized the variation to be the sum of preanalytic and analytical variability, as well as intraindividual biological variability. There is a large body of work regarding within-person variation and the meaning of differences between sequential laboratory results ( 5, 6). Analogous to the SPEP M-spike, a 50% decrease has been suggested as a partial response criterion ( 1, 4). In addition, in the absence of a measurable serum or urine M-spike, the International Myeloma Working Group (IMWG) has recommended that se-rum free light chain (FLC) concentration be used to monitor disease if the monoclonal (involved) FLC (iFLC) concentration is ≥100 mg/L in the presence of an abnormal FLC κ/λ ratio (rFLC). Serum immunoglobulin concentrations, often assessed as a quality check for changes in the SPEP M-spike, may be especially useful when the M-spike is >20–30 g/L ( 3) or if the electrophoretic migration of a monoclonal IgA, or rarely IgM, is obscured within the β fraction. A complete response requires the absence of a monoclonal protein detected by immunofixation electrophoreses. The urine M-spike, however, requires at least a 50% and 90% decrease for minimal and partial responses ( 1, 2). In serum, reductions in the M-spike of at least 25% and 50% are considered minimal and partial responses, respectively ( 1, 2). ![]() Guidelines for MM disease monitoring recommend the use of the serum M-spike if it is ≥10 g/L (i.e., measurable) and urine M-spike if ≥200 mg/24 h ( 1). In addition, these measures are commonly assessed in patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM) as indicators of progression. Serum protein electrophoresis (SPEP) 4 and/or urine protein electrophoresis (UPEP) M-spike quantifications can distinguish polyclonal and monoclonal immunoglobulins and are used in multiple myeloma (MM) to detect response to treatment or relapse. These abnormal proteins may be monitored by a variety of methods. Plasma cell proliferative disorders are commonly associated with the synthesis and secretion of a monoclonal immunoglobulin. ![]()
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