{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:57:38Z","timestamp":1792843058306,"version":"4.5.0"},"reference-count":42,"publisher":"Walter de Gruyter GmbH","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Monoclonal gammopathies are characterised by the production of a monoclonal immunoglobulin or free light chains by an abnormal plasma cell or B-cell clone and may indicate malignancy or a precursor (MGUS). There is currently no consensus on the initial test or combination of tests to be performed in suspected monoclonal gammopathies but serum protein electrophoresis and urine protein electrophoresis are commonly requested as initial investigations. If abnormal, immunofixation electrophoresis is then performed to confirm the presence of paraprotein and to determine its heavy and light chain type. Recently, some groups have developed simplified \u201cscreening\u201d IFE methods for use in parallel to SPEP for the detection monoclonal gammopathies. We argue here that screening IFE may be of benefit in clinical laboratories using SPEP with poor resolution in the \u03b2-region, assisting in the detection of mainly IgA paraprotein, but may be of less benefit in laboratories utilising higher resolution gels. Further it may increase the detection of trace bands of questionable clinical significance, representing transient phenomena in infectious and auto-immune conditions or very low risk MGUS. The increased detection of these bands using screening IFE would require further patient follow up, possibly causing unnecessary patient anxiety and additional follow up healthcare costs.<\/jats:p>","DOI":"10.1515\/cclm-2015-0806","type":"journal-article","created":{"date-parts":[[2015,12,17]],"date-time":"2015-12-17T17:18:27Z","timestamp":1450372707000},"source":"Crossref","is-referenced-by-count":7,"title":["Should routine laboratories stop doing screening serum protein electrophoresis and replace it with screening immune-fixation electrophoresis? No quick fixes: Counterpoint"],"prefix":"10.1515","volume":"54","author":[{"given":"Joel D.","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Raines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans G.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref121","first-page":"114","article-title":"Clinical relevance of trace bands on serum electrophoresis in patients without a history of gammopathy","volume":"26","year":"2015","journal-title":"Journal of the International Federation of Clinical Chemistry and Laboratory Medicine"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.cca.2013.08.018","article-title":"Serum free light chains in clinical laboratory diagnostics","volume":"427","year":"2014","journal-title":"Clin Chim Acta"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"5412","DOI":"10.1182\/blood-2008-12-194241","article-title":"Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study","volume":"113","year":"2009","journal-title":"Blood"},{"key":"ref341","first-page":"114","article-title":"Clinical relevance of trace bands on serum electrophoresis in patients without a history of gammopathy","volume":"26","year":"2015","journal-title":"Journal of the International Federation of Clinical Chemistry and Laboratory Medicine"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1093\/clinchem\/46.8.1230","article-title":"Understanding and identifying monoclonal gammopathies","volume":"46","year":"2000","journal-title":"Clin Chem"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","year":"2014","journal-title":"Lancet Oncol"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00277-011-1293-1","article-title":"Prevalence and progression of monoclonal gammopathy of undetermined significance and light-chain MGUS in Germany","volume":"91","year":"2012","journal-title":"Ann Hematol"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1373\/clinchem.2008.116400","article-title":"Screening algorithms for monoclonal gammopathies","volume":"54","year":"2008","journal-title":"Clin Chem"},{"key":"ref101","first-page":"981","article-title":"Combined light chain immunofixation to detect monoclonal gammopathy: a comparison to standard electrophoresis in serum and urine","volume":"52","year":"2014","journal-title":"Clin Chem Lab Med"},{"key":"ref321","first-page":"981","article-title":"Combined light chain immunofixation to detect monoclonal gammopathy: a comparison to standard electrophoresis in serum and urine","volume":"52","year":"2014","journal-title":"Clin Chem Lab Med"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1258\/acb.2011.011158","article-title":"Recommendations for standardized reporting of protein electrophoresis in Australia and New Zealand","volume":"49","year":"2012","journal-title":"Ann Clin Biochem"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00277-011-1293-1","article-title":"Prevalence and progression of monoclonal gammopathy of undetermined significance and light-chain MGUS in Germany","volume":"91","year":"2012","journal-title":"Ann Hematol"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"4701","DOI":"10.1182\/blood-2010-10-299529","article-title":"Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3","volume":"117","year":"2011","journal-title":"Blood"},{"key":"ref261","first-page":"105","article-title":"Screening panels for monoclonal gammopathies: time to change","volume":"30","year":"2009","journal-title":"Clin Biochem Rev"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1038\/leu.2010.60","article-title":"Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management","volume":"24","year":"2010","journal-title":"Leukemia"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","year":"2014","journal-title":"Lancet Oncol"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"4701","DOI":"10.1182\/blood-2010-10-299529","article-title":"Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3","volume":"117","year":"2011","journal-title":"Blood"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1373\/clinchem.2009.126664","article-title":"Screening panels for detection of monoclonal gammopathies","volume":"55","year":"2009","journal-title":"Clin Chem"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1258\/acb.2011.011158","article-title":"Recommendations for standardized reporting of protein electrophoresis in Australia and New Zealand","volume":"49","year":"2012","journal-title":"Ann Clin Biochem"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1056\/NEJMoa054494","article-title":"Prevalence of monoclonal gammopathy of undetermined significance","volume":"354","year":"2006","journal-title":"N Engl J Med"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1001\/jamaoncol.2015.23","article-title":"The role of diagnosis and clinical follow-up of monoclonal gammopathy of undetermined significance on survival in multiple myeloma","volume":"1","year":"2015","journal-title":"JAMA Oncol"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1001\/jamaoncol.2015.33","article-title":"Monoclonal gammopathy of undetermined significance and multiple myeloma","volume":"1","year":"2015","journal-title":"JAMA Oncol"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1373\/clinchem.2008.116400","article-title":"Screening algorithms for monoclonal gammopathies","volume":"54","year":"2008","journal-title":"Clin Chem"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1309\/AJCPT6OWWMHITA1Y","article-title":"Laboratory persistence and clinical progression of small monoclonal abnormalities","volume":"138","year":"2012","journal-title":"Am J Clin Pathol"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clml.2014.09.004","article-title":"Determining the clinical significance of monoclonal gammopathy of undetermined significance: a SEER-Medicare population analysis","volume":"15","year":"2015","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"5412","DOI":"10.1182\/blood-2008-12-194241","article-title":"Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: a prospective study","volume":"113","year":"2009","journal-title":"Blood"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1158\/1078-0432.CCR-12-2922","article-title":"Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: a review of the current understanding of epidemiology, biology, risk stratification, and management of myeloma precursor disease","volume":"19","year":"2013","journal-title":"Clin Cancer Res"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1001\/jamaoncol.2015.23","article-title":"The role of diagnosis and clinical follow-up of monoclonal gammopathy of undetermined significance on survival in multiple myeloma","volume":"1","year":"2015","journal-title":"JAMA Oncol"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/leu.2008.291","article-title":"Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma","volume":"23","year":"2009","journal-title":"Leukemia"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"f3863","DOI":"10.1136\/bmj.f3863","article-title":"Multiple myeloma","volume":"346","year":"2013","journal-title":"Br Med J"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/leu.2008.291","article-title":"Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma","volume":"23","year":"2009","journal-title":"Leukemia"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.cca.2013.08.018","article-title":"Serum free light chains in clinical laboratory diagnostics","volume":"427","year":"2014","journal-title":"Clin Chim Acta"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1038\/leu.2010.60","article-title":"Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management","volume":"24","year":"2010","journal-title":"Leukemia"},{"key":"ref41","first-page":"105","article-title":"Screening panels for monoclonal gammopathies: time to change","volume":"30","year":"2009","journal-title":"Clin Biochem Rev"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1373\/clinchem.2009.126664","article-title":"Screening panels for detection of monoclonal gammopathies","volume":"55","year":"2009","journal-title":"Clin Chem"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1309\/AJCPT6OWWMHITA1Y","article-title":"Laboratory persistence and clinical progression of small monoclonal abnormalities","volume":"138","year":"2012","journal-title":"Am J Clin Pathol"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1001\/jamaoncol.2015.33","article-title":"Monoclonal gammopathy of undetermined significance and multiple myeloma","volume":"1","year":"2015","journal-title":"JAMA Oncol"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1093\/clinchem\/46.8.1230","article-title":"Understanding and identifying monoclonal gammopathies","volume":"46","year":"2000","journal-title":"Clin Chem"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1158\/1078-0432.CCR-12-2922","article-title":"Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: a review of the current understanding of epidemiology, biology, risk stratification, and management of myeloma precursor disease","volume":"19","year":"2013","journal-title":"Clin Cancer Res"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clml.2014.09.004","article-title":"Determining the clinical significance of monoclonal gammopathy of undetermined significance: a SEER-Medicare population analysis","volume":"15","year":"2015","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1056\/NEJMoa054494","article-title":"Prevalence of monoclonal gammopathy of undetermined significance","volume":"354","year":"2006","journal-title":"N Engl J Med"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"f3863","DOI":"10.1136\/bmj.f3863","article-title":"Multiple myeloma","volume":"346","year":"2013","journal-title":"Br Med J"}],"container-title":["Clinical Chemistry and Laboratory Medicine (CCLM)"],"original-title":[],"link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2015-0806\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T23:50:53Z","timestamp":1619049053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/cclm-2015-0806\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,1]]},"references-count":42,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1515\/cclm-2015-0806","relation":{},"ISSN":["1437-4331","1434-6621"],"issn-type":[{"value":"1437-4331","type":"electronic"},{"value":"1434-6621","type":"print"}],"subject":[],"published":{"date-parts":[[2016,1,1]]}}}