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2014 | 27 | 3 | 165-170
Tytuł artykułu

Comparison of the free and total light chain assays in serum and urine samples with immunofixation electrophoresis for detecting monoclonal proteins in patients with monoclonal gammopathy

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Monoclonal protein (M-protein) is produced by a malignant clone of plasma cells. Detected in serum and/or urine, this typically indicates multiple myeloma (MM) or other monoclonal gammopathy (MG). In a majority of MM cases, with the production of intact monoclonal immunoglobulin (Ig), malignant plasmocytes and/or B lymphocytes often produce excessive amounts of free light chains (FLCs). Excessive synthesis of FLCs lowers the ability of renal proximal tubules to re-absorb FLCs, which results in abnormally high levels of FLCs in the urine (Bence Jones protein, BJP). In laboratory practice, there are tests available for the quantitative measurement of only FLCs κ and λ or for total light chains (TLCs). These tests measure both free forms and bound in the (Ig) molecules forms as light chains that are evident in the serum and in urine. The purpose of this study was to evaluate the FLCs and TLCs approaches in screening serum and urine samples of patients with MM, doing so in comparison to the results of immunofixation (IFE) assessment. A second purpose was to assess the suitability of the collected material for obtaining the most reliable results. The results of serum FLCs (sFLCs) assays suggest that this approach is of the highest reliability and diagnostic usefulness in the detection of MG with excess production of FLCs, in comparison to other available tests. In our work, when κ band light chains were detected in serum IFE (sIFE), 91% patients had their FLCs concentrations beyond the reference range, whereas 89% patients had increased λ FLCs when λ band light chains were detected in sIFE. We also found abnormal sFLC κ/λ ratios in 86.4% and 88.9% of all subject patients who had κ or λ band light chains detected in their sIFE, respectively.
Wydawca

Rocznik
Tom
27
Numer
3
Strony
165-170
Opis fizyczny
Daty
wydano
2014-09-01
otrzymano
2014-10-17
zaakceptowano
2014-10-23
online
2015-03-03
Twórcy
  • Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland, m.korpysz@gmail.com
  • The Clinic of Hematooncology and Bone Marrow Transplantation, SPSK 1, Lublin
autor
  • Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds
  • Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland
Bibliografia
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  • 3. Bradwell A.R.: Serum Free Light Chain Analysis. 6th ed. Bradwell 2010.
  • 4. Bradwell A.R. et al.: Serum test for assessment of patients with Bence Jones myeloma. Lancet. 361, 489, 2003.
  • 5. Brouwer J., Otting-van de Ruit M., Busking-van der Lely H.: Estimation of free light chains of immunoglobulins by enzyme immunoassay. Clin. Chim. Acta., 150, 267, 1985.
  • 6. Dispenzieri A. et al.: Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma. Blood. 111, 785, 2008.[WoS]
  • 7. Dispenzieri A. et al.: Appraisal of immunoglobulin free light chain as a marker of response. Blood. 111, 4908, 2008.[WoS]
  • 8. Herzog W., Hoffman W.: Detection of free kappa and lambda light chains in serum and urine in patients with monoclonal gammopathy. Blood 102, 5190a, 2003.
  • 9. Jaskowski T.D., Litwin C.M., Hill H.R.: Detection of kappa and lambda light chain monoclonal proteins in human serum: automated immunoassay versus immunofixation electrophoresis. Clin. Vaccine. Immunol., 13, 277, 2006.[Crossref]
  • 10. Jenner E: Serum free light chains in clinical laboratory diagnostics. Clin. Chim. Acta 427, 15, 2014.[WoS]
  • 11. Katzmann J.A., Abraham R.S., Dispenzieri A.: Diagnostic performance of quantitative kappa and lambda free light chain assays in clinical practice. Clin. Chem., 51, 878, 2005.
  • 12. Katzmann J.A., Clark R.J., Abraham R.S.: Serum reference intervals and diagnostic ranges for free kappa and free lambda immunoglobulin light chains: relative sensitivity for detection of monoclonal light chains. Clin. Chem., 48, 1437, 2002.
  • 13. Katzmann J.A., Kyle R.A., Benson J.: Screening panels for detection of monoclonal gammopathies. Clin. Chem., 55, 1517, 2009.[WoS]
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  • 16. Korpysz M., Malecha-Jędraszek A., Donica H.: Blood serum free light chain concentration vs. Immunofixation results in patients with monoclonal gammopathy. Curr. Iss. Pharm. Med. Sci., 25, 430, 2012.[Crossref]
  • 17. Lachmann H.J. et al.: Outcome in systemic AL amyloidosis in relation to changes in concentration of circulating free immunoglobulin light chains following chemotherapy. Br. J. Haematol., 122, 78, 2003.
  • 18. Levinson S.S.: Complementarily of urine analysis and serum free light chain assay for assessing response treatment response: illustrated by three case examples. Clin. Chim. Acta., 412, 2206, 2011.[WoS]
  • 19. Levinson S.S.: Urine immunofixation electrophoresis remains important and is complementary to serum free light chain. Clin. Chem. Lab. Med., 49, 1801, 2011.[WoS][Crossref]
  • 20. Levinson S.S., Keren D.F.: Free light chains of immunoglobulins: clinical laboratory analysis. Clin. Chem., 40, 1869, 1994.
  • 21. Marien G. et al.: Detection of monoclonal proteins in sera by capillary zone electrophoresis and free light chain measurements. Clin. Chem., 48, 1600, 2002.
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  • 23. Siegel D. et al.: Inaccuracies in 24-Hour Urine Testing for Monoclonal Gammopathies. Lab. Med., 40, 341, 2009.[Crossref]
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  • 25. Snozek C.L. et al.: Prognostic value of the serum free light chain ratio in newly diagnosed myeloma: proposed incorporation into the international staging system. Leukemia. 22, 1933, 2008.[WoS][Crossref]
  • 26. Snyder M.R. et al.: Quantification of urinary light chains. Clin. Chem., 54, 1744, 2008.[WoS][Crossref]
  • 27. Solling K. et al.: Free light chains of immunoglobulins in serum from patients with leukaemias and multiple myeloma. Scand. J. Haematol., 28, 309, 1982.[Crossref]
  • 28. Tate J.R. et al.: Analytical performance of serum free light-chain assay during monitoring of patients with monoclonal light-chain diseases. Clin. Chim. Acta., 376, 30, 2007.[WoS]
  • 29. Usnarska-Zubkiewicz L., Hołojda J., Kuliczkowski K.: Serum free light chain (sFLC) - diagnostic and prognostic value in plasma cell dyscrasias. Acta Haematol. Pol., 40, 349, 2009.
  • 30. Van Hoeven K.H. et al.: Serum free light chain assays are more sensitive than urinary tests for free light chain monoclonal paraproteins. Clin. Chem., 55, C30a, 2009.
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Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_cipms-2015-0008
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