Objective To study the morphological characteristic of immunoglobulin(Ig) isotype switch and oli-goclonal protein bands in immune fixation electrophoresis(IFE) atlas and its significance to effect evaluation of bone marrow implantation in patients with multiple myeloma(MM ) .Methods Sixty-four MM patients treated in our hos-pital during 2004 - 2014 were selected .The atlas data of serum protein electrophoresis and IFE in the patients with bone marrow implantation were compared between before and after implantation and performed the statistical analy-sis .Results Among 64 cases of MM ,48 .4% of cases had Ig isotype switch and (or) oligoclonal protein bands .The median time of the first appearance of abnormal protein band (APB ) was 1 .8 months after transplant (0 - 29 months) .The IFE results demonstrated that 71 .0% of cases had IgG kappa isotype switch as first appearance ,IgG lambda accounted for 9 .7% ,IgA kappa for 3 .2% ,IgA lambda for 9 .7% ,IgM kappa for 3 .2% and LC for 3 .2% .Af-ter transplantation ,first appearance of IgG kappa isotype switch was more common .The EFS rates in the patients ap-pearing APB and non-APB were 43% and 0 respectively ,the difference was statistically significant (P = 0 .049) ;the CR rates were 86 .7% and 61 .5% respectively with statistical difference(P= 0 .03) .Until the follow up end ,in the 5-year OS comparison between 31 cases of APB and 33 cases of non-APB ,which were 83% and 57% respectively with-out statistical difference(P= 0 .12) .Conclusion The APB appearance during MM treatment process often prompts higher curative effect and better prognosis .The interpretation and correct cognition of newly appeared APB charac-teristics also affect the correct judgment of the curative effect .%目的：探讨 Ig 同型转换及寡克隆蛋白条带在免疫固定电泳（IFE）图谱中的形态特点及其对多发性骨髓瘤（MM ）患者骨髓移植疗效评价的意义。方法选取2004～2014年本院收治的 MM 患者64例，比较患者行骨髓移植前后血清蛋白电泳及 IFE 图谱资料，并进行分析与统计。结果64例 MM 患者中，48．4％出现 Ig 同型转换和（或）寡克隆蛋白条带。异常蛋白条带（APB）首次出现中位数时间为移植后1．8（0～29）月。血清 IFE 结果提示71．0％的患者首先出现的是 IgG kappa 同型转换，IgG lambda 占9．7％，IgA kappa 占3．2％，IgA lambda 占9．7％， IgM kappa 占3．2％，LC 占3．2％。移植后首先出现是以 IgG kappa 同型转换为多见。出现 APB 的患者与非 APB患者无进展生存率分别为43％和0，差异有统计学意义（P＝0．049）；完全缓解率分别为86．7％和61．5％，差异有统计学意义（P＝0．03）。至随访结束，31例 APB 患者与33例非 APB 患者比较5年生存期，分别为83％和57％，差异无统计学意义（P＝0．12）。结论 MM 治疗过程中出现 APB 往往提示疗效更高，预后更好。对 MM 治疗过程中新出现 APB 特点的解释及正确认识也将影响疗效评价的正确判断。
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