Abstract
e19565 Background: Serum free light chain (sFLC) analysis for detection and monitoring of monoclonal gammopathies has been validated by several studies but none from India. We report sFLC in Indian healthy subjects and myeloma patients. Methods: Serum samples from 73 healthy subjects and 39 myeloma patients were analyzed using serum protein electrophoresis, immunofixation where appropriate and estimation of sFLC, the latter using FREELITE reagent kit and Hitachi-912 autoanalyzer. Parameters evaluated were κ and λ levels, κ/λ ratio and dFLC (involved-uninvolved chain). Results: Median age of controls (50 males, 23 females) was 40 years (range 20–65 years) and of patients (34 males, 5 females) was 53.5 years (range 35–80 years). In control group, λ levels were significantly higher than κ. There were 26 of kappa- and 13 of lambda- type myeloma as judged by immunofixation. Results were significantly different between myeloma and control group for κ, λ and κ/λ ratio (p=0.00). Only thirteen patients had iFLC >100 mg/L but ratios were abnormal in all (100%) patients (26 κ, 13 λ) when judged by the full range of normal κ/λ (0.51–1.66). dFLC >50 mg/L with abnormal ratio was seen in 28 (70%) patients. All patients had concordance with immunofixation. Conclusions: Healthy Indian subjects have higher κ and λ values than reported, possibly because of greater incidence of subclinical infections. However κ/λ range is comparable and iFLC >100mg/l appears uncommon. The κ/λ ratio is highly sensitive method for myeloma detection. Results need validation in larger cohort of healthy subjects and patients. No significant financial relationships to disclose.
Published Version
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