Analytical Criticalities Associated to Different Immunological Methods for Serum Free Light Chain Detection in Plasma Cell Dyscrasias: A Description of Particular Clinical CasesReportar como inadecuado


Analytical Criticalities Associated to Different Immunological Methods for Serum Free Light Chain Detection in Plasma Cell Dyscrasias: A Description of Particular Clinical Cases


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1

Division of Laboratory Medicine, Department of Pathology and Laboratory Diagnostics, Istituto Nazionale Tumori -Fondazione G. Pascale-, IRCCS, Naples 80131, Italy

2

Pathology Unit, Department of Pathology and Laboratory Diagnostics, Istituto Nazionale Tumori -Fondazione G. Pascale-, IRCCS, Naples 80131, Italy



These authors contributed equally to this work.





*

Author to whom correspondence should be addressed.



Academic Editor: William Chi-shing Cho

Abstract Current criteria for differential diagnosis of multiple myeloma MM, Monoclonal gammopathy of undetermined significance MGUS, and smoldering multiple myeloma SMM are included in the 2003 guidelines by the International Myeloma Working Group IMWG. An updated version was then published in 2014, highlighting the importance of serum free light chain sFLC detection, as well as the κ-λ ratio as excellent indicators of clonality. At present, two commercial assays for sFLC quantification are available: the Freelite™ assay and the N-Latex assay. The first was developed by The Binding Site based on a mixture of polyclonal antibodies directed against a variety of FLC epitopes. It may be run on a wide range of nephelometers, as well as on turbidimeters. The second method was developed by Siemens and runs exclusively on Siemens instruments. It employs a probe mixture of mouse monoclonal antibodies. The aim of our study was to evaluate sFLC measurement and calculated κ-λ ratio in 85 patients with monoclonal gammopathies MGs in order to compare methods. We demonstrated that there is only a moderate concordance between the two FLC assays. In particular, in one case, we observed no qualitative alterations of the serum protein pattern, and in the absence of a Freelite™ assay, sFLC measurement would not have been possible to highlight the increase of λ FLC. View Full-Text

Keywords: plasma cell dyscrasias; multiple myeloma; serum free light chains plasma cell dyscrasias; multiple myeloma; serum free light chains





Autor: Rocco Sabatino 1,†, Antonio Perrone 1,†, Marco Cuomo 1, Sandra Liotti 1, Vittoria Barchiesi 1, Monica Cantile 2 and Ernesta Cavalcanti 1,*

Fuente: http://mdpi.com/



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