Abstract
The 6th International Symposium on Clinical Applications of Serum Free Light Chain Analysis (plus Hevylite) was held in Bath, UK on 23rd and 24th September 2010. This Symposium included measurements in monoclonal gammopathies, myeloma kidney and inflammatory diseases; data from the Multi-centre, Phase III, Randomised control trial on extended haemodialysis with the Gambro protein-leaking HCO 1100 dialyser; and presentations on Hevylite (intact immunoglobulin kappa/lambda ratios) in a variety of clinical situations.
Highlights
Intact immunoglobulin - heavy chain/light chain (HLC) ratios (Hevylite)[1,2] The important clinical applications of serum free light chains (FLC) k/λ ratios have stimulated the analysis of k/λ ratios for the M-spike based upon specific immunoassays for IgGk, IgGλ, IgAk and IgAλ
In the last samples prior to progression, the isotype suppression of heavy chain classes increased to 54%, while isotype specific HLC suppression rose to 95%
The highest sensitivity of the conducted tests was reached by a combination of the three tests: sIFE, uIFE, and serum free light chain (sFLC) k/λ ratio. 97.2% of patients with MM and 96.6% patients with monoclonal gammopathy of undetermined significance (MGUS) were found positive with this method and with the recommended reference interval for sFLC ratio
Summary
Intact immunoglobulin - heavy chain/light chain (HLC) ratios (Hevylite)[1,2] The important clinical applications of serum FLC k/λ ratios have stimulated the analysis of k/λ ratios for the M-spike based upon specific immunoassays for IgGk, IgGλ, IgAk and IgAλ. All 42 cases of multiple myeloma patients showed abnormal ratio of serum FLCs while SPE could detect monoclonal protein in 36 (85.7%) out of 42 cases. Laboratory screening guidelines written by the International Myeloma Working Group, recommend serum protein electrophoresis (SPE) plus immunofixation electrophoresis (IFE), for identifying monoclonal intact immunoglobulins, and determining serum free light chain (FLC) ratios for identifying monoclonal free light chain production This protocol entails a combination of both nephelometry/turbidimetry and gel electrophoresis, which can require a degree of expert interpretation. Recent studies utilising assays specific for heavy chain/light chain (HLC) pairs have indicated that HLC ratios (IgGk/IgGλ, IgAk/IgAλ, IgMk/IgMλ) provide a sensitive indication of monoclonal intact immunoglobulin production This raises the possibility of developing monoclonal gammopathy screening protocols based upon the use of both HLC and FLC ratios. Storage of samples for FLC or HLC analysis at 22°C for 2 days does not have a detrimental effect on subsequent storage at 4°C or -20°C
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
