Newly Diagnosed Monoclonal Gammopathies in 2024 in a Single Center: A Retrospective Study from a Perspective of Initial Testing in Diagnosis

Background: There is no consensus on the initial testing in diagnosing monoclonal gammopathies (MG).This retrospective analysis reports on newly diagnosed MG patients at the University of Health Sciences Türkiye, Antalya Training and Research Hospital and assesses the necessity of serum immunofixation electrophoresis (SIFE) as an initial diagnostic test. Materials and Methods: All serum protein electrophoresis (SPE) tests performed and reported between 1 January 2024 and 31December 2024 were retrospectively reviewed from the institute's archival database.Patients with any electrophoresis test results and patients without any previous electrophoresis test results were included in the study.Results: Our laboratory diagnosed 115 new patients with MG in 2024.Of these 115 patients, 67 (58%) were male and 48 (42%) were female, with mean ages of 65.98 ± 10.78 years in men and 66.22 ± 10.37 years in women.Sixty-three of 115 patients were positive on both the SPE and the serum free lightchain ratio (rFLC).Of 115 patients, 31 were positive only for SPE and negative for rFLC, whereas 5 were positive only for rFLC and negative for SPE.Six of 115 patients were negative for both SPE and rFLC, but were diagnosed by a positive SIFE.Conclusion: After a retrospective review of 115 newly diagnosed MG patients in 2024, we concluded that 6 of these patients might have been missed (undiagnosed) if a combination of SPE + rFLC tests had been used as the initial diagnostic tests.None of these six cases showed a measurable M protein on SPE, nor did they receive medication for MG.