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. 2024 Mar 18;14(1):50. doi: 10.1038/s41408-024-00995-y

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — The workflow for analysis of a serum sample by FLC-MS is shown in (A). B shows example mass spectra of how FLC-MS is used to track monoclonal FLC across serial samples. An example mass spectrum from a polyclonal sample run against free kappa is shown in the top mass spectrum. At presentation monoclonal kappa FLC with an m/z of 11781 for the doubly charged light chain were identified. Persistent residual monoclonal kappa FLC are detectable by FLC-MS (peak at m/z 11785 for the doubly charged light chain) at the end of induction chemotherapy. There is also an oligoclonal peak within the postinduction spectrum with a completely distinct m/z to the monoclonal light chain. At the postmaintenance time point there are no residual monoclonal kappa FLC detectable by FLC-MS. There is a very small abnormality in the kappa FLC spectrum (m/z 11713 for the doubly charged light chain) which is likely due to a very small oligoclonal peak.