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An online educational resource with continuously updated information on serum free light chain and Hevylite® analysis.
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Light Chain Multiple Myeloma
Detect Light Chain Multiple Myeloma First Time
Freelite® is a suitable alternative to 24-hour urine testing in the diagnosis and monitoring of light chain multiple myeloma.
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| Freelite® results can be plotted on a dot plot. Blue triangles and black squares show patients with myeloma. You can see that both SPE and IFE sensitivity is not sufficient to detect all patients with myeloma. |
Approximately 15% of MM patients have only monoclonal free light chain and no monoclonal intact immunoglobulin secreted by the malignant clone. These patients are difficult to diagnose as they frequently show no abnormality when tested by serum protein electrophoresis (SPE). For this reason it has historically been recommended that a 24 hour urine collection is tested for the presence of monoclonal free light chains. However, urine tests for free light chains can be negative early in the disease as the capacity for reabsorption of light chains by the kidneys must be exceeded before free light chains appear in the urine.
Other contributory factors to the inherent difficulty of the urine assay are patient compliance to a 24 hour urine collection together with inaccuracy and poor precision of the technique itself.
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Fig 2: ...the Freelite® serum free light chain proved sensitive enough for correlation with clinical events Copyright 2004 Wiley. Used with permission from Alyanakian et al. American Journal of Hematology, Wiley Interscience. www.interscience.wiley.com |
By using serum as the test medium, the problems associated with urine assays can be overcome. In a recent study,1 serum measurements of Freelite® free light chains were used to detect 100% of patients with LCMM.
For some patients, e.g. patient 6 in Figure 2, urine free light chain concentrations are too low for reliable quantification. However, Freelite® serum free light chains can be measured at all times.2
Summary
- Detect the Multiple Myeloma patients that frequently show no abnormality by serum protein electrophoresis (SPE)
- Freelite® serum assays are more sensitive than conventional urine methods
- Freelite® is now recommended by International Myeloma Working Group guidelines
Patient Management
Patient ManagementFreelite® is a valuable tool at all stages of patient management. It is useful when screening to support an initial diagnosis. It adds valuable prognosis information and can be used throughout treatment management as a reliable monitoring tool.
- A.R. Bradwell, et al. Serum test for assessment of patients with Bence Jones myeloma. Lancet 2003; 361: 489-491 Request your copy - code MKG189
- Marie-Alexandra Alyanakian, et al. Free Immunoglobulin Light-Chain Serum Levels in the Follow-up of Patients With Monoclonal Gammopathies: Correlation With 24-hr Urinary Light-Chain Excretion. Am J Hematology 2004; 75: 246-248 Request your copy - code MKG222
