Serum and urine electrophoresis, immunofixation and free light chains
What SPEP, immunofixation, urine studies and serum free light chains each detect, which combination to order for myeloma, AL amyloid and neuropathy, reading the FLC ratio with renal function (iStopMM eGFR ranges), IMWG response thresholds and the 2025 to 2026 revision, and the traps: daratumumab bands, fibrinogen, beta-region IgA and light chain MGUS.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
Loading the rest of the note…
Finished reading?
Sources
- International Myeloma Working Group updated criteria for the diagnosis of multiple myelomaRajkumar SV et al., Lancet Oncol 2014;15:e538-48, 2014
- International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myelomaKumar S et al., Lancet Oncol 2016;17:e328-46, 2016
- IMWG-IMS consensus workshop summaries: updated response criteria (presented at the 2025 IMS Annual Meeting, Toronto)International Myeloma Working Group, reported by Pharmacy Times, September 2025
- Defining new reference intervals for serum free light chains in individuals with chronic kidney disease: results of the iStopMM studyLong TE et al., Blood Cancer J 2022;12:133, 2022
- Serum reference intervals and diagnostic ranges for free kappa and free lambda immunoglobulin light chainsKatzmann JA et al., Clin Chem 2002;48:1437-44, 2002
- Screening panels for detection of monoclonal gammopathiesKatzmann JA et al., Clin Chem 2009;55:1517-22, 2009
- MBS items 71057 (serum or urine electrophoresis) and 71200 (serum free light chains)AU/NZAustralian Government Department of Health, Disability and Ageing, MBS Online, November 2026
- MSAG clinical practice guidelines for multiple myelomaAU/NZMedical Scientific Advisory Group to Myeloma Australia, 2026
- RCPA Manual (protein electrophoresis, immunofixation, free light chains)AU/NZRoyal College of Pathologists of Australasia
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main