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- Title
The serum heavy/light chain immunoassay: A valuable tool for sensitive paraprotein assessment, risk, and disease monitoring in monoclonal gammopathies.
- Authors
Greil, Christine; Ihorst, Gabriele; Gaiser, Felix; Salzer, Ulrich; Bisse, Emanuel; Kastritis, Efstathios; Ludwig, Heinz; Wäsch, Ralph; Engelhardt, Monika
- Abstract
Objective The heavy/light chain ( HLC)-immunoassay quantifies light chain types of each immunoglobulin class in patients with monoclonal gammopathies. Methods We assessed 147 consecutive patients with different forms and stages of plasma cell dyscrasias ( PCD) who received standard tests (serum and urine protein electrophoresis [ SPEP, UPEP], immunofixation [ IFE], serum-free light chain [ SFLC]), and HLC-immunoassay. Patients with multiple myeloma ( MM, n = 102), smoldering MM ( SMM, n = 5), monoclonal gammopathy of undetermined significance ( MGUS, n = 28), and Waldenström's macroglobulinemia ( WM, n = 12) were included. Results We verified a significant correlation between HLC- and standard monoclonal protein (mp)-parameters, and HLC-increases with higher disease stage and unfavorable remission status. In patients with difficult to quantify mp, more abnormal HLC- than SPEP-, immunoglobulin-, or SFLC-results were found. In WM, a pathological HLC κ/λ-ratio and M-component were observed in 95% and 58%, respectively. In 21/28 MGUS and 5/5 SMM patients, HLC κ/λ-ratios were abnormal. Testing different HLC cutoffs, patients with extreme HLC values showed impaired progression-free survival ( PFS). Conclusions Despite the fact that different PCD patients were included, the assessment of the HLC-immunoassay in MGUS, SMM, MM, and WM, our comparison with standard mp-assays, and relevant PFS differences may excite future applications, which should be confirmed in prospective multicenter trials.
- Subjects
MONOCLONAL gammopathies; IMMUNOASSAY; PLASMA cell diseases; PROTEIN analysis; IMMUNOGLOBULINS; DISEASE remission; MULTIPLE myeloma; PATIENTS; DIAGNOSIS
- Publication
European Journal of Haematology, 2017, Vol 99, Issue 5, p449
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12958