ABSTRACT
There are a number of diseases, including myeloma, that are associated with clonal proliferation of B lymphocytes. Biochemical investigations play an important role in their diagnosis, prognosis, and monitoring. The monoclonal immunoglobulin resulting from the clonal proliferation of the B cells is an important tumor marker and reliable detection, typing, and quantification of the monoclonal protein (M-protein or paraprotein) is vital. Measurement of proteins related to B-cell function or turnover, e.g. the polyclonal background immunoglobulins or 2-microglobulin, can give indications of tumor burden and prognosis. Additionally, in the investigation of patients with B-cell dyscrasias, a wide range of biochemical markers are useful to monitor renal function, bone and calcium metabolism, infection, and the effects of treatments. Where possible, laboratories offering any of the investigations discussed in this chapter should participate in appropriate external quality assurance (EQA) schemes (a list of EQA providers is shown in Appendix A).
