HOW TO IDENTIFY MONOCLONAL PROTEINS IN MULTIPLE MYELOMA? 1) SPEP will demonstrate a localized band or peak in 82 percent of patients with myeloma . 2) Addition of serum protein immunofixation electrophoresis increases the sensitivity to 93 percent and also determines its type. 3) The addition of either the serum free light chain (FLC) assay or urine monoclonal protein studies (urine protein electrophoresis and urine immunofixation) increase the sensitivity to 97 percent or more. NOTE : Patients who lack detectable M protein by any of these tests are considered to have non-secretory myeloma (3%). KEY MESSAGE: So when you have strong suspicion of myeloma a panel of 3 should be ordered