We use actual patient sample as controls, usually with a single 20-g/L
M-protein spike in gamma region. Statistics is generated for both
albumin and M protein fractions. In each run day, at least one QC is run
on each of the 8 capillary columns on our instrument before any patient
samples are run. We don't bother about normal controls and there will be
plenty of normals in a run that usually comprises of ~80-100 samples.
Commercial controls typically have no beta-fraction due to breakdown of
complements during processing and serve little purpose in our 6-band
"high resolution" electrophoresis (ie. Beta1 and beta2 fractions
resolved & reported separately).
Regards,
PC Chan
Sunnybrook Health SC,
Ontario, Canada
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Christine Collier
Sent: Tuesday, October 04, 2011 10:54 AM
To: [log in to unmask]
Subject: Re: Paraprotein quantitation
Hi Angela,
For accreditation, we are supposed to do what we say and say what we do
(in
our policies and procedures, P&Ps). So, I went to see what ours
currently
say...
In our SPE P&P:
Quality Control
Quality control is run once per box of gel. Results of the control
sample are
recorded in LIS.
In our IF P&P:
Quality Control
As directed by the Clinical Chemist responsible for interpretation and
validation of all SPE, UPE and IFE patterns, Quality control consists
of: *
the delta check by the Clinical Chemist and technologist of the patient
file
(paper record) of both regular and monoclonal proteins.
* Visual correlation of simultaneous protein patterns with Qigs
* Chemical (Modular) and electrophoretic albumin concentration
correlations *
Quality and consistency is constantly reviewed visually by Clinical
Chemist
NOTE: SPE and IFE protein investigations are only recommended for
screening
and monitoring of monoclonal proteins
So, most of the things in the IF P&P could be added to the SPE P&P. The
issue
is that QCing using a control without an (faint) M-Band does then not QC
for
the purpose of the procedure, which is to detect M-Bands. Certainly
when we
evaluate new SPE systems we challenge them in this fashion.
QCing using a normal control would QC for the quantitation of normal
fraction
concentrations, and we do report these concentrations. However, I have
noted
that the purchase QC material often has low Beta protein levels.
If the QC was considered as a "normal" control only...then, I would
point out
that we have never had a gel with only monoclonol patients on it...there
are
always normals on each gel of 30 lanes.
Another "QC" feature that we are fortunate to have, is that we rotate
the
interpretations monthly between the 2 clinical chemists here, so for
patients
with more than one sample, the previous (scans, IFs) come up to us in a
file
(with all serum and urine results on that patient) for comparison...thus
standardizing and providing internal checking to some extent.
So, I have anticipated that question, but not sure we have the perfect
answer
yet.
Looking forward to other comments,
Christine
> Dear all,
> We recently had a CPA inspection and one of our non-conformances was
the
lack of internal QC for the quantitation of paraproteins by
> electrophoresis.
> I would be interested to hear what (?if) other labs have in place.
Happy to
summarise any responses I get.
> Thanks in anticipation
> Angela
> Angela Kremmyda
> Senior Biochemist
> Dept of Clinical Biochemistry
> Royal Shrewsbury Hospital
> Mytton Oak Road
> Shrewsbury
> SY3 8XQ
> Tel: 01743 261158
> Fax: 01743 261159
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Christine Collier, PhD FCACB,
Service Chief, Clinical Chemistry,
Kingston General Hospital
Associate Professor, Queen's University
Phone: 613-549-6666 ext 4137
FAX results: 613-548-2429
FAX general: 613-548-6076
Pager: 613-536-7571
Cell: 613-541-8055
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community
working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the
internet. Views expressed are those of the individual and they are
responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical community working in clinical biochemistry.
Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
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