Sequencing of the M protein. Toward personalized medicine in monoclonal gammopathies

Abstract

Each patient with a monoclonal gammopathy has a unique monoclonal (M) protein, whose sequence can be used as a tumoral fingerprint to track the presence of the B cell or plasma cell (PC) clone itself. Moreover, the M protein can directly cause potentially life-threatening organ damage, which is dictated by the specific, patient's unique clonal light and/or heavy chain amino acid sequence, as in patients affected by immunoglobulin light chain (AL) amyloidosis.1 However, patients' specific M protein sequences remain mostly undefined and molecular mechanisms underlying M protein-related clinical manifestations are largely obscure.