scholarly journals A Patient of Multiple Myeloma with Absent M-spike on Serum Protein Electrophoresis and Elevated Serum-Free Light Chains: A Case Report and Literature Review

Cureus ◽  
2019 ◽  
Author(s):  
Areej Lalani ◽  
Kashif Aziz ◽  
Mehreen Khan ◽  
Tayyaba Zubair ◽  
Syed Ijlal Ahmed
Keyword(s):  
Multiple Myeloma ◽  
Case Report ◽  
Literature Review ◽  
Elevated Serum ◽  
Protein Electrophoresis ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains ◽  
M Spike

scholarly journals Clinical usefulness of serum free light chains measurement in patients with multiple myeloma: comparative analysis of two different tests

2017 ◽  
Vol 71 (0) ◽  
pp. 40-46
Author(s):  
Tadeusz Kubicki ◽  
Dominik Dytfeld ◽  
Aleksandra Baszczuk ◽  
Ewa Wysocka ◽  
Mieczysław Komarnicki ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Protein Electrophoresis ◽  
Light Chains ◽  
Weak Correlation ◽  
Free Light Chains ◽  
Urine Protein ◽  
Serum Free ◽  
Activity Assessment ◽  
Serum Free Light Chains ◽  
Disease Activity Assessment

<b>Introduction:</b> There are two commercially available tests for measurement of serum free light chains (sFLC) in multiple myeloma (MM) patients – Freelite and N Latex FLC. The aim of this study was to perform an assessment and direct comparison of the usefulness of the methods in routine clinical practice.<br/><b>Methods:</b> 40 refractory/relapsed MM patients underwent routine disease activity assessment studies, along with sFLC analysis using both assays. Correlation and concordance between the tests and sensitivity of studied methods of sFLC assessment were established. Special attention was focused on sFLC results in patients finally evaluated after completing the treatment. <br/><b>Results:</b> A weak correlation for the measurement of both κ [Passing–Bablok slope (PB) = 0.7681] and λ chains [(PB) = 1.542] was found. Using Bland–Altman plots, a bias of 0.0467 (κ) and -0.2133 (λ) between the measurements was documented. The concordance coefficient equaled 0.87 for κ, 0.62 for λ and 0.52 for κ/λ ratio. Ten patients had an abnormal Freelite assay κ/λ ratio and normal N Latex FLC κ/λ ratio. Three of these patients had negative serum protein electrophoresis results and fulfilled diagnostic criteria of stringent complete remission (sCR) according to N Latex FLC (but not according to Freelite). When the κ/λ ratio obtained by both methods was compared to patients’ serum/urine protein electrophoresis and immunofixation results, sensitivity of Freelite and N Latex FLC was established to be 62.5% and 41%, respectively. <br/><b>Conclusions:</b> There was no strong correlation or concordance between the two assays, and the sensitivity in terms of sFLC detection was different. This may cause problems when diagnosis of sCR is considered.

scholarly journals Bleeding due to acquired dysfibrinogenemia as the initial presentation of multiple myeloma

2019 ◽  
Vol 12 (7) ◽  
pp. e229312
Author(s):  
Namrah Siddiq ◽  
Colin Bergstrom ◽  
Larry D Anderson ◽  
Srikanth Nagalla
Keyword(s):  
Multiple Myeloma ◽  
Activity Level ◽  
Initial Presentation ◽  
Bleeding Complications ◽  
Light Chains ◽  
Bleeding Diathesis ◽  
Antigen Level ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains

Patients with multiple myeloma (MM) are at risk for acquired dysfibrinogenemia resulting in laboratory abnormalities and/or bleeding complications. We describe a 63-year-old man who presented with bleeding diathesis in the presence of a low fibrinogen activity level with a normal fibrinogen antigen level. Further studies revealed elevated levels of lambda free light chains, and he was diagnosed with MM. Despite initiating treatment with bortezomib/dexamethasone, he continued to have recurrent bleeds along with hypofibrinogenaemia, prompting a switch to carfilzomib/dexamethasone. The patient responded with improvement in bleeding symptoms, normalisation of fibrinogen activity and a decrease in serum free light chains.

scholarly journals Serum free light chains and multiple myeloma: Is it time to extend their application?

2020 ◽  
Vol 8 (4) ◽  
pp. 617-624
Author(s):  
Uros Markovic ◽  
Valerio Leotta ◽  
Daniele Tibullo ◽  
Rachele Giubbolini ◽  
Alessandra Romano ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains

Impact of Novel M-Component Based Biomarkers On to Progression Free Survival After Treatment in Intact Immunoglobulin Multiple Myeloma.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2927-2927
Author(s):  
Efstathios Koulieris ◽  
Dimitrios Maltezas ◽  
Nikolaou Eytychia ◽  
Vassiliki Bartzis ◽  
Tatianna Tzenou ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Binding Site ◽  
Progression Free Survival ◽  
Normal Serum ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Depth Of Response ◽  
Serum Free Light Chains

Abstract Abstract 2927 Background and Aims: Multiple Myeloma (MM) is characterized by bone marrow (BM) plasma cell infiltration and the presence of serum/urine monoclonal immunoglobulin (Ig). The depth of response has been associated with longer PFS in MM causing subsequent prolonged survival. Recently novel M-based biomarker immunoassays have been developed (Freelite™, Hevylite™) and their significance in MM diagnosis and prognosis has been demonstrated.1,2 Furthermore serum Free Light Chains (sFLC) are used for better assessment of treatment response, thus patients are considered to achieve stringed Complete Response (sCR) by having CR criteria plus normal serum Free Light Chains Ratio (sFLCR) and absent clonal cells on BM.3 The significance of Hevylite™ on response has not been assessed so far. Patients in nCR or better do not automatically restore their ratio of intact monoclonal Ig/intact polyclonal Ig of the same class (Hevylite™ or HLCR). We therefore investigated the importance of sFLCR and HLCR normalisation at plateau on PFS, in a series of patients with intact Ig MM. Patients and Methods: 50 intact immunoglobulin MM patients were studied from diagnosis to last follow up. Immunofixation was IgG (26 -kappa and 12 –lamdba) and IgA (6 –kappa and 6 -lambda). All patients were symptomatic at diagnosis. Sera samples (n=312) were analyzed for sFLC-kappa and sFLC-lambda with Freelite™ and sFLCR were calculated, and for IgGkappa, IgGlambda IgAkappa, IgAlambda with Hevylite™ and ratios IgGkappa/IgGlambda, IgGlambda/IgGkappa, IgAkappa,/IgAlambda and IgAlambda/IgAkappa (HLCRs) were calculated. sFLCRs and HLCRs values above the 95%-ile of normal individuals were considered abnormal. Statistical analysis was performed using SPSS ver 15.0. File data were reviewed. Results: At diagnosis sFLCR was abnormal in 86% of patients while HLCR was abnormal in all. All treatment lines were initiated according to standard criteria and median lines of therapy were 2 (range 1–11). Median follow up was 33 months (7–145). During patients' cumulative follow-up, 145 lines of therapy were studied and the subsequent responses were estimated. Thirty eight percent of responses were sCR, CR and nCR, 20% PR, 18% MR and 24% refractory and progressive disease. HLCR normalized in 44% of patients with sCR, CR and nCR. The depth of response correlated to PFS and patients in sCR, CR and nCR had longer PFS than the others (p<0.001). Serum FLCR and HLCR normal values at response were both strong parameters of increased PFS after treatment at any line (p=0.035 and p=0.046 respectively). Conclusion: Serum HLCR normalization at plateau reflects prolonged responses in intact Ig MM. Disclosures: Harding: Binding Site: Employment. Bradwell:The Binding Site: shareholder Other.

scholarly journals Elevated Serum Free Light Chains Predict Cardiovascular Events in Type 2 Diabetes: Table 1

Diabetes Care ◽  
2014 ◽  
Vol 37 (7) ◽  
pp. 2028-2030 ◽  
Author(s):  
Srikanth Bellary ◽  
Jeffrey M. Faint ◽  
Lakhvir K. Assi ◽  
Colin A. Hutchison ◽  
Stephen J. Harding ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Elevated Serum ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains

scholarly journals Response to: Serum free light chains for monitoring multiple myeloma

2005 ◽  
Vol 128 (3) ◽  
pp. 406-407 ◽  
Author(s):  
Graham P. Mead ◽  
Hugh Carr-Smith ◽  
Mark T. Drayson ◽  
Gareth T. Morgan ◽  
Anthony J. Child
Keyword(s):  
Multiple Myeloma ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains

1139 ABNORMALLY ELEVATED SERUM FREE LIGHT CHAINS IN PATIENTS WITH LIVER DISEASE

2010 ◽  
Vol 52 ◽  
pp. S440-S441 ◽  
Author(s):  
L.K. Assi ◽  
R.G. Hughes ◽  
B. Gunson ◽  
G.M. Webb ◽  
M.T. Drayson ◽  
...  
Keyword(s):  
Liver Disease ◽  
Elevated Serum ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Serum Free Light Chains

scholarly journals Extracorporeal light chains removal – What role does this play in 2020?

2021 ◽  
Vol 34 (4) ◽  
Author(s):  
Inês Coelho ◽  
◽  
Hugo Ferreira ◽  
Teresa Chuva ◽  
Ana Paiva ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Kidney Injury ◽  
Rapid Decrease ◽  
Light Chains ◽  
Free Light Chains ◽  
Monoclonal Immunoglobulin ◽  
Serum Free ◽  
Cast Nephropathy ◽  
Cell Clones ◽  
Serum Free Light Chains

Multiple Myeloma (MM) is characterized by a neoplastic proliferation of plasma cell clones producing monoclonal immunoglobulin. Manifestations of the disease are heterogenous and include dialysis­‑requiring acute kidney injury (AKI) caused mainly by cast nephropathy (CN). It is known that early and rapid decrease in serum free light chains (sFLC) levels is particularly important for renal recovery, which has led to a renewed interest in extracorporeal methods of removal of sFLC. In this review we will discuss the management of light chain CN focusing on extracorporeal light chains removal modalities and their indication.

4.1 Elevated Serum Free Light Chains Independently Identify a Poor Risk Group of Stage A CLL Patients

2011 ◽  
Vol 11 ◽  
pp. S218 ◽  
Author(s):  
Guy Pratt ◽  
Philip J. Young ◽  
Chris Pepper ◽  
Chris Fegan ◽  
Anne Gardiner ◽  
...  
Keyword(s):  
Risk Group ◽  
Elevated Serum ◽  
Light Chains ◽  
Free Light Chains ◽  
Serum Free ◽  
Poor Risk ◽  
Serum Free Light Chains
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