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Serum free light chains for monitoring multiple myeloma
Author(s) -
Mead G. P.,
CarrSmith H. D.,
Drayson M. T.,
Morgan G. J.,
Child J. A.,
Bradwell A. R.
Publication year - 2004
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2004.05045.x
Subject(s) - multiple myeloma , immunoglobulin light chain , plasma cell , bence jones protein , antibody , bone marrow , medicine , monoclonal , beta 2 microglobulin , myeloma protein , monoclonal antibody , concordance , immunology , microbiology and biotechnology , biology
Summary Monoclonal immunoglobulin free light chains (FLC) are found in the serum and urine of patients with a number of B‐cell proliferative disorders, including multiple myeloma. Automated immunoassays, which can measure FLC in serum, are useful for the diagnosis and monitoring of light chain (AL) amyloidosis, Bence Jones myeloma and non‐secretory myeloma patients. We report the results of a study investigating the utility of serum FLC measurements in myeloma patients producing monoclonal intact immunoglobulin proteins. FLC concentrations were measured in presentation sera from 493 multiple myeloma patients with monoclonal, intact immunoglobulin proteins. Serial samples were assayed from 17 of these patients and the FLC measurements were compared with other disease markers. Serum FLC concentrations were abnormal in 96% of patients at presentation. FLC concentrations fell more rapidly in response to treatment than intact immunoglobulin G (IgG) and showed greater concordance with serum β 2 microglobulin concentrations and bone marrow plasma cell assessments. It was concluded that serum FLC assays could be used to follow the disease course in nearly all multiple myeloma patients. In addition, because of their short serum half‐life, changes in serum FLC concentrations provide a rapid indication of the response to treatment.