Serum free light chain analysis in multiple myeloma and plasma cell dyscrasias

2011 ◽  
Vol 7 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Guner Hayri Ozsan ◽  
Angela Dispenzieri
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Light Chain ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Chain Analysis ◽  
Plasma Cell Dyscrasias

Kidney disease and plasma cell dyscrasias: ambiguous cases solved by serum free light chain dimerization analysis

2019 ◽  
Vol 23 (6) ◽  
pp. 763-772
Author(s):  
Olga Kukuy ◽  
Batia Kaplan ◽  
Sizilia Golderman ◽  
Alexander Volkov ◽  
Adrian Duek ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Plasma Cell ◽  
Light Chain ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Plasma Cell Dyscrasias

scholarly journals International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders

Leukemia ◽  
2008 ◽  
Vol 23 (2) ◽  
pp. 215-224 ◽  
Author(s):  
A Dispenzieri ◽  
◽  
R Kyle ◽  
G Merlini ◽  
J S Miguel ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Light Chain ◽  
Working Group ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Chain Analysis ◽  
International Myeloma Working Group

Assessment of Serum Free Light Chain Assay for Screening for Plasma Cell Disorders.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2563-2563
Author(s):  
David E. Smith ◽  
Jude Abadie ◽  
Daniel Bankson ◽  
Graham Mead
Keyword(s):  
Multiple Myeloma ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Plasma Cell ◽  
Light Chain ◽  
Predictive Value ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Plasma Cell Disorders

Abstract Introduction and Methods: The purpose of this study was to evaluate the serum free light chain (FLC) assay in its ability to improve performance of protocols designed to screen for plasma cell disorders. We measured M-protein levels using serum protein electrophoresis (SPEP) in 312 consecutive patients being screened for plasma cell disorders at the Veterans Administration Medical Center - Puget Sound. The serum kappa and lambda free light chain levels were quantitated using the serum FLC assay in these same patients. The kappa/lambda ratio was calculated using the free kappa and free lambda results from the serum FLC assay. Results: SPEP results indicated the presence of a possible monoclonal gammopathy in 77 of the 312 patients in this study. In this group of 77 patients, a plasma cell disorder was diagnosed in 27 of them. The serum FLC assay showed an abnormal kappa/lambda ratio in 20 of these 77 patients, all 20 of whom were diagnosed with multiple myeloma. In the group of 235 patients with normal SPEP results, 17 were found to have an abnormal kappa/lambda ratio. Of these 17 patients, 15 were diagnosed with multiple myeloma, one with lymphoma, and one with bladder cancer. Conclusions: Because a number of disorders and diseases can increase production of immunoglobulins, there were a significant number of false positives in the SPEP results. At the same time, there were also several false negative SPEP results. The number of both false positives and false negatives was smaller for the serum FLC assay. Further, use of SPEP and the serum FLC assay together resulted in significantly improved sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). (See Table 1.) These results indicate an important role for the serum FLC assay in screening for monoclonal gammopathies. Table 1. Performance of SPEP, sFLC, and both assays in screening for plasma cell disorders SPEP Alone sFLC Alone Both SPEP and sFLC Sensitivity 64% 88% 100% Specificity 81% 98% 99% Positive Predictive Value 35% 88% 89% Negative Predictive Value 94% 98% 100%

scholarly journals Serum Free Light Chain Analysis and Urine Immunofixation Electrophoresis in Patients with Multiple Myeloma

2005 ◽  
Vol 11 (24) ◽  
pp. 8706-8714 ◽  
Author(s):  
Mohammad R. Nowrousian ◽  
Dieter Brandhorst ◽  
Christiane Sammet ◽  
Michaela Kellert ◽  
Rainer Daniels ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Light Chain ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Chain Analysis ◽  
Immunofixation Electrophoresis

scholarly journals Is accuracy of serum free light chain measurement achievable?

2016 ◽  
Vol 54 (6) ◽  
Author(s):  
Joannes F.M. Jacobs ◽  
Jillian R. Tate ◽  
Giampaolo Merlini
Keyword(s):  
Plasma Cell ◽  
Light Chain ◽  
Free Light Chain ◽  
Clinical Consequence ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Quantitative Monitoring ◽  
Plasma Cell Disorders ◽  
Prognostic Stratification ◽  
Plasma Cell Dyscrasias

AbstractThe serum free light chain (FLC) assay has proven to be an important complementary test in the management of patients with monoclonal gammopathies. The serum FLC assay has value for patients with plasma cell disorders in the context of screening and diagnosis, prognostic stratification, and quantitative monitoring. Nonetheless, serum FLC measurements have analytical limitations which give rise to differences in FLC reporting depending on which FLC assay and analytical platform is used. As the FLC measurements are incorporated in the International Myeloma Working Group guidelines for the evaluation and management of plasma cell dyscrasias, this may directly affect clinical decisions. As new certified methods for serum FLC assays emerge, the need to harmonise patient FLC results becomes increasingly important. In this opinion paper we provide an overview of the current lack of accuracy and harmonisation in serum FLC measurements. The clinical consequence of non-harmonized FLC measurements is that an individual patient may or may not meet certain diagnostic, prognostic, or response criteria, depending on which FLC assay and platform is used. We further discuss whether standardisation of serum FLC measurements is feasible and provide an overview of the steps needed to be taken towards harmonisation of FLC measurements.

The serum-free light chain assay cannot replace 24-hour urine protein estimation in patients with plasma cell dyscrasias

Blood ◽  
2007 ◽  
Vol 109 (8) ◽  
pp. 3611-3612 ◽  
Author(s):  
Seema Singhal ◽  
Regina Stein ◽  
Eric Vickrey ◽  
Jayesh Mehta
Keyword(s):  
Plasma Cell ◽  
Light Chain ◽  
Free Light Chain ◽  
Urine Protein ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Protein Estimation ◽  
Plasma Cell Dyscrasias

scholarly journals A monoclonal gammopathy precedes multiple myeloma in most patients

Blood ◽  
2009 ◽  
Vol 113 (22) ◽  
pp. 5418-5422 ◽  
Author(s):  
Brendan M. Weiss ◽  
Jude Abadie ◽  
Pramvir Verma ◽  
Robin S. Howard ◽  
W. Michael Kuehl
Keyword(s):  
Multiple Myeloma ◽  
Serum Protein ◽  
Plasma Cell ◽  
Light Chain ◽  
Monoclonal Gammopathy ◽  
Protein Electrophoresis ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Chain Analysis ◽  
Immunofixation Electrophoresis

Preexisting plasma cell disorders, monoclonal gammopathy of undetermined significance, or smoldering myeloma are present in at least one-third of multiple myeloma patients. However, the proportion of patients with a preexisting plasma cell disorder has never been determined by laboratory testing on prediagnostic sera. We cross-referenced our autologous stem cell transplantation database with the Department of Defense Serum Repository. Serum protein electrophoresis, immunofixation electrophoresis, and serum free light-chain analysis were performed on all sera collected 2 or more years before diagnosis to detect a monoclonal gammopathy (M-Ig). In 30 of 90 patients, 110 prediagnostic samples were available from 2.2 to 15.3 years before diagnosis. An M-Ig was detected initially in 27 of 30 patients (90%, 95% confidence interval, 74%-97%); by serum protein electrophoresis and/or immunofixation electrophoresis in 21 patients (77.8%), and only by serum free light-chain analysis in 6 patients (22.2%). Four patients had only one positive sample within 4 years before diagnosis, with all preceding sera negative. All 4 patients with light-chain/nonsecretory myeloma evolved from a light-chain M-Ig. A preexisting M-Ig is present in most multiple myeloma patients before diagnosis. Some patients progress rapidly through a premalignant phase. Light-chain detected M-Ig is a new entity that requires further study.

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