Table 1.

List of IMWG recommendations regarding mass spectrometry.

Intact LC MALDI-TOF can be used in lieu of immunofixation in the clinically assessment of patients and the assessment of patients on clinical trials.

We endorse the use of mass spectrometry to aid in distinguishing therapeutic antibodies from endogenous M-proteins.

We recognize that using mass spectrometric methods in lieu of conventional IFE may lead to lower rates of CR, and therefore cross-comparisons of CR rates in trials done in different time periods is not recommended.

We endorse the collection of further data from mass spectrometry (MALDI-TOF, miRAMM, or clonotypic peptide approach) to document the ability to test for MRD negativity in the peripheral blood, and to guide timing of BM tests for next-generation flow cytometry and NGS studies.

We encourage further investigations to further clarify the relationship and implications of N-linked glycosylation in MGUS progression to myeloma and AL amyloidosis.