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International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders

Dispenzieri, A.; Kyle, R.; Merlini, G.; Miguel, J. S.; Ludwig, H.; Hajek, R.; Palumbo, A.; Jagannath, S.; Blade, J. and Lonial, S., et al. (2009) In Leukemia 23(2). p.215-224
Abstract
The serum immunoglobulin-free light chain (FLC) assay measures levels of free kappa and lambda immunoglobulin light chains. There are three major indications for the FLC assay in the evaluation and management of multiple myeloma and related plasma cell disorders (PCD). In the context of screening, the serum FLC assay in combination with serum protein electrophoresis (PEL) and immunofixation yields high sensitivity, and negates the need for 24-h urine studies for diagnoses other than light chain amyloidosis (AL). Second, the baseline FLC measurement is of major prognostic value in virtually every PCD. Third, the FLC assay allows for quantitative monitoring of patients with oligosecretory PCD, including AL, oligosecretory myeloma and nearly... (More)
The serum immunoglobulin-free light chain (FLC) assay measures levels of free kappa and lambda immunoglobulin light chains. There are three major indications for the FLC assay in the evaluation and management of multiple myeloma and related plasma cell disorders (PCD). In the context of screening, the serum FLC assay in combination with serum protein electrophoresis (PEL) and immunofixation yields high sensitivity, and negates the need for 24-h urine studies for diagnoses other than light chain amyloidosis (AL). Second, the baseline FLC measurement is of major prognostic value in virtually every PCD. Third, the FLC assay allows for quantitative monitoring of patients with oligosecretory PCD, including AL, oligosecretory myeloma and nearly two-thirds of patients who had previously been deemed to have non-secretory myeloma. In AL patients, serial FLC measurements outperform PEL and immunofixation. In oligosecretory myeloma patients, although not formally validated, serial FLC measurements reduce the need for frequent bone marrow biopsies. In contrast, there are no data to support using FLC assay in place of 24-h urine PEL for monitoring or for serial measurements in PCD with measurable disease by serum or urine PEL. This paper provides consensus guidelines for the use of this important assay, in the diagnosis and management of clonal PCD. (Less)
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Contribution to journal
publication status
published
subject
keywords
myeloma, amyloid, immunoglobulin-free light chain, prognosis
in
Leukemia
volume
23
issue
2
pages
215 - 224
publisher
Nature Publishing Group
external identifiers
  • wos:000263312300001
  • scopus:60149096306
ISSN
1476-5551
DOI
10.1038/leu.2008.307
language
English
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yes
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954f2854-6598-4f2d-94ad-7aef449a66b7 (old id 1374876)
date added to LUP
2009-05-08 17:38:57
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2017-12-10 04:17:57
@article{954f2854-6598-4f2d-94ad-7aef449a66b7,
  abstract     = {The serum immunoglobulin-free light chain (FLC) assay measures levels of free kappa and lambda immunoglobulin light chains. There are three major indications for the FLC assay in the evaluation and management of multiple myeloma and related plasma cell disorders (PCD). In the context of screening, the serum FLC assay in combination with serum protein electrophoresis (PEL) and immunofixation yields high sensitivity, and negates the need for 24-h urine studies for diagnoses other than light chain amyloidosis (AL). Second, the baseline FLC measurement is of major prognostic value in virtually every PCD. Third, the FLC assay allows for quantitative monitoring of patients with oligosecretory PCD, including AL, oligosecretory myeloma and nearly two-thirds of patients who had previously been deemed to have non-secretory myeloma. In AL patients, serial FLC measurements outperform PEL and immunofixation. In oligosecretory myeloma patients, although not formally validated, serial FLC measurements reduce the need for frequent bone marrow biopsies. In contrast, there are no data to support using FLC assay in place of 24-h urine PEL for monitoring or for serial measurements in PCD with measurable disease by serum or urine PEL. This paper provides consensus guidelines for the use of this important assay, in the diagnosis and management of clonal PCD.},
  author       = {Dispenzieri, A. and Kyle, R. and Merlini, G. and Miguel, J. S. and Ludwig, H. and Hajek, R. and Palumbo, A. and Jagannath, S. and Blade, J. and Lonial, S. and Dimopoulos, M. and Comenzo, R. and Einsele, H. and Barlogie, B. and Anderson, K. and Gertz, M. and Harousseau, J. L. and Attal, M. and Tosi, P. and Sonneveld, P. and Boccadoro, M. and Morgan, G. and Richardson, P. and Sezer, O. and Mateos, M. V. and Cavo, M. and Joshua, D. and Turesson, Ingemar and Chen, W. and Shimizu, K. and Powles, R. and Rajkumar, S. V. and Durie, B. G. M.},
  issn         = {1476-5551},
  keyword      = {myeloma,amyloid,immunoglobulin-free light chain,prognosis},
  language     = {eng},
  number       = {2},
  pages        = {215--224},
  publisher    = {Nature Publishing Group},
  series       = {Leukemia},
  title        = {International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders},
  url          = {http://dx.doi.org/10.1038/leu.2008.307},
  volume       = {23},
  year         = {2009},
}