Clinical usefulness of serum free light chain measurement in monoclonal gammopathy

DOI Web Site 1 Citations 25 References
  • SHIMAZAKI Chihiro
    Division of Hematology and Oncology, Kyoto Prefectural University of Medicine (current address: Department of Hematology, Social Insurance Kyoto Hospital)
  • MURAKAMI Hirokazu
    School of Health Science, Faculty of Medicine, Gunma University
  • SAWAMURA Morio
    Department of Hematology, National Hospital Organization Nishigunma National Hospital
  • MATSUDA Masayuki
    Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine
  • KINOSHITA Tomohiro
    Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
  • HATA Hiroyuki
    Department of Hematology, Kumamoto University Hospital
  • SUGIURA Isamu
    Division of Hematology and Oncology, Toyohashi Municipal Hospital
  • TSUSHITA Keitaroh
    Department of Hematology, Social Insurance Chukyo Hospital
  • NAGURA Eiichi
    Department of Internal Medicine, Tokoname Municipal Hospital
  • KOSUGI Hiroshi
    Department of Hematology, Ogaki Municipal Hospital
  • ITOH Junji
    Department of Laboratory Medicine, Nagoya City Midori General Hospital
  • SHIMIZU Kazuyuki
    Department of Medicine, Nagoya City Midori General Hospital

Bibliographic Information

Other Title
  • 単クローン性<i>γ</i>グロブリン血症における血清遊離軽鎖測定の臨床的有用性
  • 臨床研究 単クローン性γグロブリン血症における血清遊離軽鎖測定の臨床的有用性
  • リンショウ ケンキュウ タンクローンセイ ガンマ グロブリン ケツショウ ニ オケル ケッセイ ユウリ ケイサ ソクテイ ノ リンショウテキ ユウヨウセイ

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Description

Recently, a highly sensitive assay (FREELITE™) capable of measuring serum immunoglobulin-free light chains (FLC) was developed. An abnormal κ/λ ratio supports the presence of clonal plasma cell expansion. Using this assay, we measured serum and urine samples of 178 healthy volunteers, 184 patients with polyclonal γ-globulinemia and 150 patients with monoclonal γ-globulinemia. The diagnostic sensitivity of the FLC assays for monoclonal gammopathies was 88.0% and the specificity for healthy volunteers and polyclonal gammopathies was 96.1%. The minimal detection sensitivity of this assay for serum FLC was 0.3 mg/l and was greater than 100-fold more sensitive than serum protein electrophoresis (SPE). The combination of FLC with SPE and immunoelectrophoresis identified 99% of patients with monoclonal gammopathies. Effective treatment often leads to a more rapid reduction of the involved FLC level relative to the intact immunoglobulin or total light chain concentration because the half-life of FLC is <6 hours. These observations suggest that FREELITE™ is useful for diagnosis, disease monitoring and assessment of response to treatment in patients with monoclonal gammopathies such as multiple myeloma and AL amyloidosis.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 51 (4), 245-252, 2010

    The Japanese Society of Hematology

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