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Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Background

The process for the detection of monoclonal gammopathies (MGs) is highly complex. To obtain an accurate diagnosis, diagnostic data must be compiled from several areas of the laboratory (eg, total protein, immunoglobulin levels, gel or capillary electrophoreses patterns).

Scope

A primary goal of this guideline would be evidence-based recommendations for the laboratory detection and initial diagnosis of MGs. The scope includes testing modalities in peripheral blood and urine, and excludes testing on bone marrow. Key questions include what is an adequate sample (what specimens to collect and test), what clinical information should be included in a laboratory order, and which laboratory tests to use in which patients and recommendations for appropriate ancillary testing. The scope will also include the reinforcement of the International Myeloma Working Group “Criteria for Diagnosis of Multiple Myeloma” for testing and reporting.

Key Questions

  • What specimens are useful in the detection of MGs?
  • What are the appropriate tests needed to accurately detect and quantify MGs?

Status

Research and review.

Collaborators

Association for Clinical Chemistry

American Society for Clinical Pathology 

American Society of Hematology

International Myeloma Working Group 

Panel Members

David Keren, MD, FCAP, Co-chair

M. Qasim Ansari, MD, FCAP, Co-chair

Gregary Bocsi, DO, FCAP

Joan Etzell, MD, FCAP 

James Faix, MD, FCAP

Shaji Kumar, MD

Brea Lipe, MD

Christopher McCudden, PhD

Roberta Montgomery, MLS(ASCP)cmSI(ASCP)

Alex Rai, PhD

Teresita Redondo, MD, FCAP

Lesley Souter, PhD

Brooke Billman, MLIS

Christina B. Ventura, MPH, MT(ASCP) 

Additional Information

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