Specimen Collection

4 mL SST Serum (Preferred)

4 mL Plain Serum
Turnaround Time:

Between 5 and 8 days

Diagnostic Use and Interpretation

Monoclonal gammopathies

If a monoclonal band is detected by electrophoresis, immunofixation will be performed to identify it and band quantitation will be performed by densitometry.

Band quantitation is the recommended method for monitoring patients who have a quatifiable paraprotein band in serum. Band quantitation will always be performed on all samples from the patient. The uncertainty of measurement for band quantitation is 15%.

Quantitation of urine monoclonal light chains (Bence-Jones protein) is done by densitometry and is reported as the paraprotein / creatinine ratio.

Immunofixation will only be performed on the initial sample, unless the pattern of bands changes.

Immunofixation is not usually performed if the electrophoresis pattern looks normal. However, in cases of neuropathy (where inflammatory demyelinating neuropathy is suspected) it is necessary to do immunofixation; in these cases "NEUROPATHY - immunofixation required" should be written clearly on the request form under Clinical Details.

The free light chains assay is useful in amyloidosis, light chain myeloma, and non-secretory myeloma. This assay has a very high imprecision and should not be used for monitoring myeloma / MGUS patients with a quantifiable paraprotein band in serum. See Free Light Chains - blood

Both urine and serum specimens should be tested if myeloma is suspected. 20% of myeloma patients have an abnormal band in the urine, but not in the serum.

Contact Information

For any further information contact the chemical pathologist via email chemicalpathologist@adhb.govt.nz or via Lablink (Auckland City Hospital) EXT 22000 or 09 3078995.

Dr Cam Kyle (Clinical Head): CampbellK@adhb.govt.nz ext 22052

Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427

Dr Samarina Musaad : SamarinaM@adhb.govt.nz ext. 22402

Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427

Dr Sakunthala Jayasinghe : sakunthala@adhb.govt.nz ext. 23427

Dr Owen Yi (Registrar): wenyiyi@adhb.govt.nz ext. 22045

Last updated at 12:09:03 16/07/2025