{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:54:39Z","timestamp":1792450479898,"version":"4.5.0"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"12","license":[{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["#10817"],"award-info":[{"award-number":["#10817"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2021-0399_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The therapeutic monoclonal antibody (t-mAb) daratumumab, used to treat multiple myeloma (MM) patients, interferes with routine, electrophoretic based M-protein diagnostics. Electrophoretic response assessment becomes increasingly difficult when multiple t-mAbs are combined for use in a single patient. This is the first study to address the analytical challenges of M-protein monitoring when multiple t-mAbs are combined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0399_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this proof-of-principle study we evaluate two different methods to monitor M-protein responses in three MM patients, who receive both daratumumab and nivolumab. The double hydrashift assay aims to resolve t-mAb interference on immunofixation. The MS-MRD (mass spectrometry minimal residual disease) assay measures clonotypic peptides to quantitate both M-protein and t-mAb concentrations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0399_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After exposure to daratumumab and nivolumab, both t-mAbs become visible on immunofixation electrophoresis (IFE) as two IgG-kappa bands that migrate close to each other at the cathodal end of the \u03b3-region. In case the M-protein co-migrates with these t-mAbs, the observed interference was completely abolished with the double IFE hydrashift assay. In all three patients the MS-MRD assay was also able to distinguish the M-protein from the t-mAbs. Additional advantage of the MS-MRD assay is that this multiplex assay is more sensitive and allows quantitative M-protein-, daratumumab- and nivolumab-monitoring.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0399_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Daratumumab and nivolumab interfere with electrophoretic M-protein diagnostics. However, the M-protein can be distinguished from both t-mAbs by use of a double hydrashift assay. The MS-MRD assay provides an alternative method that allows sensitive and simultaneous quantitative monitoring of both the M-protein and t-mAbs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2021-0399","type":"journal-article","created":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T20:04:27Z","timestamp":1629057867000},"page":"1963-1971","source":"Crossref","is-referenced-by-count":27,"title":["Monitoring the M-protein of multiple myeloma patients treated with a combination of monoclonal antibodies: the laboratory solution to eliminate interference"],"prefix":"10.1515","volume":"59","author":[{"given":"Somayya","family":"Noori","sequence":"first","affiliation":[{"name":"Department of Neurology , Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie P. M.","family":"Verkleij","sequence":"additional","affiliation":[{"name":"Department of Hematology , Amsterdam University Medical Center, Vrije Universiteit Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-2771","authenticated-orcid":false,"given":"Marina","family":"Zajec","sequence":"additional","affiliation":[{"name":"Department of Neurology , Erasmus University Medical Center , Rotterdam , The Netherlands"},{"name":"Department of Clinical Chemistry , Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Langerhorst","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Radboud University Medical Center , Nijmegen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia W. C.","family":"Bosman","sequence":"additional","affiliation":[{"name":"Department of Hematology , Amsterdam University Medical Center, Vrije Universiteit Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda B.","family":"de Rijke","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry , Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Zweegman","sequence":"additional","affiliation":[{"name":"Department of Hematology , Amsterdam University Medical Center, Vrije Universiteit Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"VanDuijn","sequence":"additional","affiliation":[{"name":"Department of Neurology , Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Luider","sequence":"additional","affiliation":[{"name":"Department of Neurology , Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels W. 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