M-spike Frequency and Serum Fraction Changes in Multiple Myeloma Assessed by Capillary Serum Protein Electrophoresis in and around Chennai, Southern India
Abstract
Introduction: Multiple myeloma is a clonal malignancy of plasma cells characterized by the proliferation of abnormal plasma cells in the bone marrow and the excessive production of monoclonal immunoglobulin. Incidence increases with age and is slightly more common in males. Serum protein electrophoresis is a crucial diagnostic method for detecting monoclonal proteins and evaluating protein fraction abnormalities in multiple myeloma. Objectives: The present study works to evaluate serum protein electrophoresis (SPE) patterns from patients investigated for multiple myeloma in a clinical laboratory reference setting. Methods: Serum protein electrophoresis supports detection of monoclonal proteins and other protein abnormalities relevant to multiple myeloma. The method applies an electric field to separate serum proteins according to electrophoretic mobility. Multiple myeloma represents a B-cell lineage neoplasm and accounts for ~10% of haematological malignancies. Serum proteins separate into albumin and globulin fractions; albumin forms the predominant fraction, while globulin fractions migrate closer to the negative electrode. Results: M-spikes were detected in the beta region in 3.80% of electrophoresis reports and in the gamma region in 20.95% of electrophoresis reports. M-spikes were absent in 75.23% of reports. Beta gamma bridging was observed in 7.61% of electrophoresis patterns. Conclusion: Accurate SPE interpretation supported identification of clinically relevant abnormal patterns. Higher occurrence was observed among men aged 50 to 70 years. Higher alpha-1 and lower beta-1 fractions were observed in women, while men showed stronger alpha-1 and lower beta-1 fractions.
Keywords:
Haematological Malignancy, Multiple Myeloma, Serum Protein Electrophoresis
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References
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Oda, R. P., Clark, R., Katzmann, J. A., & Landers, J. P. (1997). Capillary electrophoresis as a clinical tool for the analysis of protein in serum and other body fluids. Electrophoresis, 18(10), 1715-1723. https://doi.org/10.1002/elps.1150181004
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Prisi, S., Khurana, V., Saijpaul, R., Verma, R., Chandra, L., & Koner, B. C. (2022). Unraveling the possibilities of monoclonal protein migration, identification, and characterization in SPEP on capillary zone electrophoresis. Journal of Laboratory Physicians, 14(04), 505-510. https://doi.org/10.1055/s-0042-1744242
Sjöholm, A. G., & Laurell, A. B. (1973). Conversion of the fourth complement component studied by crossed immunoelectrophoresis. Clinical and Experimental Immunology, 14(4), 515 – 529.
Solanki, A. S., Sharma, N., & Thadani, D. (2025). Pattern of Serum Protein Electrophoresis: Advances in Laboratory Medicine. Journal of Medical Evidence, 6(1), 45-52. https://doi.org/10.4103/JME.JME_103_23
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Tripathy, S. (2012). The role of serum protein electrophoresis in the detection of multiple myeloma: an experience of a corporate hospital. Journal of Clinical and Diagnostic Research: JCDR, 6(9), 1458–1461.https://doi.org/10.7860/JCDR/2012/4213.2532
Wang, M., He, L., Chang, Y., & Yan, Z. (2025). Identification of α2-macroglobulin as a biomarker for type 2 diabetes in human serum. Frontiers in Endocrinology, 16, 1534490. https://doi.org/10.3389/fendo.2025.1534490
Wang, T., Shuai, P., Wang, Q., Guo, C., Huang, S., Li, Y., ... & Yi, L. (2025). α 1 Antitrypsin is a potential target of inflammation and immunomodulation. Molecular Medicine Reports, 31(4), 107. https://doi.org/10.3892/mmr.2025.13472
Zhong, L., Dong, K., Xiao, J., & Gong, B. (2026). A new perspective on aging and multiple myeloma. Medicine Plus, 3(1), .100126.https://doi.org/10.1016/j.medp.2026.100126
Bailey, D. N., & Fitzgerald, R. L. (2024). The Laboratory Diagnosis of Protein Abnormalities. In Clinical Chemistry: A Practical Learning and Teaching Toolkit (pp. 181-211). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-67380-1_14
Camus, M. S., Krimer, P. M., Leroy, B. E., & Almy, F. S. (2010). Evaluation of the positive predictive value of serum protein electrophoresis beta–gamma bridging for hepatic disease in three domestic animal species. Veterinary Pathology, 47(6), 1064-1070. https://doi.org/10.1177/0300985810375946
Chan, P. C., Chen, Y., & Randell, E. W. (2018). On the path to evidence-based reporting of serum protein electrophoresis patterns in the absence of a discernible monoclonal protein–A critical review of literature and practice suggestions. Clinical Biochemistry, 51, 29-37. https://doi.org/10.1016/j.clinbiochem.2017.09.010
Chartier, C., Boularan, A. M., Dupuy, A. M., Badiou, S., Bargnoux, A. S., Cognot, C., ... & Cristol, J. P. (2011). Evaluation of two automated capillary electrophoresis systems for human serum protein analysis. Clinical Biochemistry, 44(17-18), 1473-1479. https://doi.org/10.1016/j.clinbiochem.2011.05.022
Duggal, N., Kumar, M., Malhotra, P., Jain, A., & Aggarwal, R. (2025). Occurrence of monoclonal band in alpha region on serum electrophoresis in multiple myeloma: a diagnostic conundrum. Indian Journal of Hematology & Blood Transfusion: An Official Journal of Indian Society of Hematology and Blood Transfusion, 41(1), 155–160. https://doi.org/10.1007/s12288-024-01793-z
Fadili, H., Ouazzani, H., Rhaleb, I., Bendi, I., Snoussi, M., Zrara, A., ... &Bakkouri, J. E. (2025). Relevance of Prescribing Serum Immunofixation Electrophoresis in the Diagnosis of Monoclonal Gammopathies. Cureus, 17(6). https://doi.org/10.7759/cureus.86339
Fend, F., Dogan, A., & Cook, J. R. (2023). Plasma cell neoplasms and related entities—evolution in diagnosis and classification. VirchowsArchiv, 482(1), 163-177. https://doi.org/10.1007/s00428-022-03431-3
Huang, S., Wei, S., Luo, F., & Cheng, Y. (2026). Alpha-1 antitrypsin as a new biomarker of inflammation, infection and disease severity in community-acquired pneumonia: A prospective cohort study. Scientific Reports. https://doi.org/10.1038/s41598-026-47772-4
Jenkins, M. A., & Guerin, M. D. (1997). Capillary electrophoresis procedures for serum protein analysis: comparison with established techniques. Journal of Chromatography B: Biomedical Sciences and Applications, 699(1-2), 257-268. https://doi.org/10.1016/s0378-4347(97)00180-1
Kuhn, R., & Hoffstetter-Kuhn, S. (2013). Capillary electrophoresis: Principles and practice. Springer Science & Business Media. https://doi.org/10.1007/978-3-642-78058-5
Kumar, A., Israr, J., & Alam, S. (2026). Advances and Applications of Single-Cell Proteomics. Advances in Single Cell Analysis, 107-132.https://doi.org/10.1007/978-981-95-9789-5_6
Landers, J. P. (1995). Clinical capillary electrophoresis. Clinical Chemistry, 41(4), 495-509. https://doi.org/10.1093/clinchem/41.4.495
Lawanson, M. O., Griffin, E., Berleant, D., Farmer, P., Hodge, R., Schinke, C., Ashby, C., & Bauer, M. A. (2025). How Does Age at Diagnosis Influence Multiple Myeloma Survival? Empirical Evidence. Healthcare, 13(20), 2637. https://doi.org/10.3390/healthcare13202637
Lee, H. C., Ailawadhi, S., Gasparetto, C. J., Jagannath, S., Rifkin, R. M., Durie, B. G., ... & Connect® MM Registry Abonour Rafat 14. (2021). Treatment patterns and outcomes in elderly patients with newly diagnosed multiple myeloma: Results from the Connect® MM Registry. Blood Cancer Journal, 11, 134. https://doi.org/10.1038/s41408-021-00524-1
Liu, X., Zhuang, H., Li, F., Shen, M., Lu, Y., & Pei, R. (2025). Trends and projections of the global and regional burden of multiple myeloma in adults aged 40 and over, 1990-2044. Scientific Reports, 15(1), 13595. https://doi.org/10.1038/s41598-025-96981-w
Mefire, K., El Mohtarim, O., Idrissi, S. E. M., Bouhsain, S., Dami, A., Biaz, A., ... & BOUHSAINE, S. (2025). Polymerized IgA Monoclonal Gammopathy Simulating Biclonal Gammopathy: A Case Report. Cureus, 17(7), e88517. https://doi.org/10.7759/cureus.88517
Navarro, P. F., Gil, L., & Fernández-Barredo, S. (2022). Evaluation of urine proteins by capillary electrophoresis. Bio-protocol, 12(15), e4466-e4466. https://doi.org/10.21769/BioProtoc.4466
Nikolac, N. (2014). Lipemia: causes, interference mechanisms, detection and management. Biochemia Medica, 24(1), 57-67. https://doi.org/10.11613/BM.2014.008
Oda, R. P., Clark, R., Katzmann, J. A., & Landers, J. P. (1997). Capillary electrophoresis as a clinical tool for the analysis of protein in serum and other body fluids. Electrophoresis, 18(10), 1715-1723. https://doi.org/10.1002/elps.1150181004
Pang, G., Kang, X., Li, Y., Zhang, X., & Ren, H. (2026). A novel fluorescent-labeled serum protein electrophoresis method for detection of monoclonal free light chains in serum. Clinical Biochemistry, 141 111067. https://doi.org/10.1016/j.clinbiochem.2025.111067
Perales-Afán, J. J., Menao, S., García-Gutiérrez, A., García-Zafra, L., Del Castillo-Díez, E., & Torralba-Cabeza, M. Á. (2025). Alpha-1 Antitrypsin Deficiency Screening Using Serum Protein Electrophoresis. Respiratory Care, 70(5), 551–558. https://doi.org/10.1089/respcare.12524
Prisi, S., Khurana, V., Saijpaul, R., Verma, R., Chandra, L., & Koner, B. C. (2022). Unraveling the possibilities of monoclonal protein migration, identification, and characterization in SPEP on capillary zone electrophoresis. Journal of Laboratory Physicians, 14(04), 505-510. https://doi.org/10.1055/s-0042-1744242
Sjöholm, A. G., & Laurell, A. B. (1973). Conversion of the fourth complement component studied by crossed immunoelectrophoresis. Clinical and Experimental Immunology, 14(4), 515 – 529.
Solanki, A. S., Sharma, N., & Thadani, D. (2025). Pattern of Serum Protein Electrophoresis: Advances in Laboratory Medicine. Journal of Medical Evidence, 6(1), 45-52. https://doi.org/10.4103/JME.JME_103_23
Tran, C., Schneider, H. G., Lam, Q. T., Neumann, J. T., Cicuttini, F., Yu, C., ... & McNeil, J. J. (2025). Elevated alpha-1 antitrypsin and C-reactive protein: association on all-cause and cause-specific mortality in older adults. GeroScience. https://doi.org/10.1007/s11357-025-01956-4
Tripathy, S. (2012). The role of serum protein electrophoresis in the detection of multiple myeloma: an experience of a corporate hospital. Journal of Clinical and Diagnostic Research: JCDR, 6(9), 1458–1461.https://doi.org/10.7860/JCDR/2012/4213.2532
Wang, M., He, L., Chang, Y., & Yan, Z. (2025). Identification of α2-macroglobulin as a biomarker for type 2 diabetes in human serum. Frontiers in Endocrinology, 16, 1534490. https://doi.org/10.3389/fendo.2025.1534490
Wang, T., Shuai, P., Wang, Q., Guo, C., Huang, S., Li, Y., ... & Yi, L. (2025). α 1 Antitrypsin is a potential target of inflammation and immunomodulation. Molecular Medicine Reports, 31(4), 107. https://doi.org/10.3892/mmr.2025.13472
Zhong, L., Dong, K., Xiao, J., & Gong, B. (2026). A new perspective on aging and multiple myeloma. Medicine Plus, 3(1), .100126.https://doi.org/10.1016/j.medp.2026.100126
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Venkatachalam, C., Gurumoorthi, M., Sbapathy, S., Rangasamy, K. and Maniraj, S. (2026) “M-spike Frequency and Serum Fraction Changes in Multiple Myeloma Assessed by Capillary Serum Protein Electrophoresis in and around Chennai, Southern India”, International Journal of Advancement in Life Sciences Research, 9(3), pp. 93-103. doi: https://doi.org/10.31632/ijalsr.2026.v09i03.008.
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