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Diagnosis and monitoring for light chain only and oligosecretory myeloma using serum free light chain tests
- Source :
- Heaney, J L J, Campbell, J P, Griffin, A E, Birtwistle, J, Shemar, M, Child, J A, Gregory, W M, Cairns, D A, Morgan, G J, Jackson, G H & Drayson, M T 2017, ' Diagnosis and monitoring for light chain only and oligosecretory myeloma using serum free light chain tests ', British Journal of Haematology, vol. 178, no. 2, pp. 220-230 . https://doi.org/10.1111/bjh.14753
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- This study aims to guide the integration of serum free light chain (sFLC) tests into clinical practice, including a new rapid test (Seralite(®) ). Blood and urine analysis from 5573 newly diagnosed myeloma patients identified 576 light chain only (LCO) and 60 non-secretory (NS) cases. Serum was tested by Freelite(®) and Seralite(®) at diagnosis, maximum response and relapse. 20% of LCO patients had urine FLC levels below that recommended for measuring response but >97% of these had adequate sFLC levels (oligosecretory). The recommended Freelite(®) sFLC ≥100 mg/l for measuring response was confirmed and the equivalent Seralite(®) FLC difference (dFLC) >20 mg/l identified. By both methods, ≥38% of NS patients had measurable disease (oligosecretory). Higher sFLC levels were observed on Freelite(®) at all time points. However, good clinical concordance was observed at diagnosis and in response to therapy. Achieving at least a very good partial response according to either sFLC method was associated with better patient survival. Relapse was identified using a Freelite(®) sFLC increase >200 mg/l and found 100% concordance with a corresponding Seralite(®) dFLC increase >30 mg/l. Both Freelite(®) and Seralite(®) sensitively diagnose and monitor LCO/oligosecretory myeloma. Rapid testing by Seralite(®) could fast-track FLC screening and monitoring. Response by sFLC assessment was prognostic for survival and demonstrates the clinical value of routine sFLC testing.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Response to therapy
Point-of-Care Systems
Concordance
Aftercare
Immunoglobulins
Urine
Immunoglobulin light chain
Sensitivity and Specificity
Gastroenterology
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Serum free
Internal medicine
Journal Article
medicine
Humans
Multiple myeloma
Retrospective Studies
Immunoassay
Very Good Partial Response
medicine.diagnostic_test
business.industry
Hematology
medicine.disease
030104 developmental biology
030220 oncology & carcinogenesis
Immunology
Immunoglobulin Light Chains
Neoplasm Recurrence, Local
Multiple Myeloma
business
Subjects
Details
- ISSN :
- 00071048
- Volume :
- 178
- Database :
- OpenAIRE
- Journal :
- British Journal of Haematology
- Accession number :
- edsair.doi.dedup.....758dbc559bb771878b9ded2fff99457d