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we now have a new test called mass spectrometry to assess light chains and heavy chains and patients with plasma cell disorder this test is more sensitive than your typical expected immuno fixation and that has been well described in various studies that have been presented before and at the American Society of Hematology meeting what mass spectrometry also helps us do is detect post translational modifications like cysteine additions glycosylation etc in the past we have shown that glycosylation of light chain results in an increased risk of al amyloidosis now cold at lieutenant disease is a hemolytic disease that is associated with an IgM Kappa M protein and not all patients with IG m Kappa get cold agglutinin disease so there has to be something about the structure of the monoclonal protein that predisposes patients to have a cold agglutinin disease just as thereamp;#39;s something predisposing patients to develop amyloidosis you know so we hypothesized that we might find glycosyla
