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- Title
Diagnosis and monitoring for light chain only and oligosecretory myeloma using serum free light chain tests.
- Authors
Heaney, Jennifer L. J.; Campbell, John P.; Griffin, Anne E.; Birtwistle, Jane; Shemar, Meena; Child, J Anthony; Gregory, Walter M.; Cairns, David A.; Morgan, Gareth; Jackson, Graham; Drayson, Mark T.
- Abstract
This study aims to guide the integration of serum free light chain ( sFLC) tests into clinical practice, including a new rapid test (Seralite®). Blood and urine analysis from 5573 newly diagnosed myeloma patients identified 576 light chain only ( LCO) and 60 non-secretory ( NS) cases. Serum was tested by Freelite® and Seralite® at diagnosis, maximum response and relapse. 20% of LCO patients had urine FLC levels below that recommended for measuring response but >97% of these had adequate sFLC levels (oligosecretory). The recommended Freelite® sFLC ≥100 mg/l for measuring response was confirmed and the equivalent Seralite® FLC difference ( dFLC) >20 mg/l identified. By both methods, ≥38% of NS patients had measurable disease (oligosecretory). Higher sFLC levels were observed on Freelite® at all time points. However, good clinical concordance was observed at diagnosis and in response to therapy. Achieving at least a very good partial response according to either sFLC method was associated with better patient survival. Relapse was identified using a Freelite® sFLC increase >200 mg/l and found 100% concordance with a corresponding Seralite® dFLC increase >30 mg/l. Both Freelite® and Seralite® sensitively diagnose and monitor LCO/oligosecretory myeloma. Rapid testing by Seralite® could fast-track FLC screening and monitoring. Response by sFLC assessment was prognostic for survival and demonstrates the clinical value of routine sFLC testing.
- Subjects
SERUM-free culture media; URINALYSIS; BLOOD testing; PROTEIN kinases; PROGRESSION-free survival
- Publication
British Journal of Haematology, 2017, Vol 178, Issue 2, p220
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.14753