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  4. Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies

Laboratory Detection and Initial Diagnosis of Monoclonal Gammopathies


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).


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. 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 to detect MGs?
  • What are the appropriate tests needed to accurately detect and quantify MGs?
  • What information should be included in the laboratory order? And which laboratory tests are best used in which patients? What appropriate ancillary testing should be recommended?


American 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)

David Murray, MD, PhD

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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