Heavy/light chain assay as a biomarker for diagnosis and follow-up of multiple myeloma

Chae, Hyojin; Han, Eunhee; Yoo, Jaeeun; Lee, Jaewoong; Lee, Jeong Joong; Cha, Kyoungho; Kim, Myungshin; Kim, Yonggoo; Lee, Sung‐Eun; Min, Chang‐Ki

doi:10.1016/j.cca.2018.01.010

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…With respect to the HLC assay, there are not many studies analyzing sequential samples once consolidation treatment is ended. However, in some clinical cases here collected, the alteration of the HLCr was observed prior to the appearance of the MP by SPEP/IFE due to the decrease in the uHLC concentration that precedes the iHLC expansion [22,26]. These findings suggest an important role of IMI as an early biomarker of relapse.…”

Section: Discussionmentioning

confidence: 62%

“…Additionally, Chae et al observed an alteration of the HLCr in two patients in CR due to decreased uHLC levels. IFE turned positive 1.5 and 3 months after the HLCr changed from normal to abnormal in these patients [22].…”

Section: At Follow-upmentioning

confidence: 77%

“…Since its introduction by Bradwell et al [18], different studies have validated the performance of the HLC assay to quantify MPs in serum, showing, in general, a good correlation between iHLC levels and the MP concentration obtained by SPEP [19][20][21][22][23][24][25]. However, some discrepancies between these techniques have been reported.…”

Section: Analytical Accuracy and Concordance With Conventional Techniquesmentioning

confidence: 99%

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The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach

et al. 2021

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Despite tremendous progress being made in recent years, multiple myeloma (MM) remains a challenging disease. The laboratory plays a critical role in the overall management of patients. The diagnosis, prognosis, clinical monitoring and evaluation of the response are key moments in the clinical care process. Conventional laboratory methods have been and continue to be the basis of laboratory testing in monoclonal gammopathies, along with the serum free light chain test. However, more accurate methods are needed to achieve new and more stringent clinical goals. The heavy/light chain assay is a relatively new test which can overcome some of the limitations of the conventional methods for the evaluation of intact immunoglobulin MM patients. Here, we report an update of the evidence accumulated in recent years on this method regarding its use in MM.

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Section: Discussionmentioning

confidence: 62%

Section: At Follow-upmentioning

confidence: 77%

Section: Analytical Accuracy and Concordance With Conventional Techniquesmentioning

confidence: 99%

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The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach

et al. 2021

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“…These assays are measured in pairs in order to provide information on monoclonal immunoglobulin production in patients with plasma cell dyscrasias and improve the accuracy of monitoring in these patients. Reductions in HLC levels are indicative of immunoparesis and are consistent with worse prognosis . Unlike in plasma cell dyscrasias, the clinical relevance of HLC measurements in CLL is yet to be studied.…”

Section: Introductionmentioning

confidence: 99%

“…Reductions in HLC levels are indicative of immunoparesis and are consistent with worse prognosis. [8][9][10][11][12][13][14] Unlike in plasma cell dyscrasias, the clinical relevance of HLC measurements in CLL is yet to be studied.…”

mentioning

confidence: 99%

A new risk model to predict time to first treatment in chronic lymphocytic leukemia based on heavy chain immunoparesis and summated free light chain

Tadmor¹,

Braester

Dally

et al. 2019

European J of Haematology

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Background Chronic lymphocytic leukemia (CLL) is frequently accompanied by immune dysregulation. Aims In this multicenter prospective study, we investigated whether heavy + light chains (HLC: IgGκ, IgGλ, IgAκ, IgAκ, IgMκ, IgMλ) and IgG subclasses (IgG1, IgG2, IgG3, and IgG4) could be used as novel prognostic markers of immunoparesis in 105 treatment‐naïve patients with CLL. Results Heavy + light chains immunoparesis of ≥1, ≥2, and ≥3 isotypes was evident in 74 (70%), 58 (55%), and 36 (34%) patients, respectively. Severe HLC immunoparesis was identified in 40 (38%) patients. Of the IgG subclasses, IgG1 and IgG2 were most frequently suppressed, affecting 46 (44%) and 36 (34%) patients, respectively; 63 (60%) patients had low levels of at least one IgG subclass. In multivariate analysis, severe HLC immunoparesis (hazard ratio [HR]: 36.5; P = .010) and ΣFLC ≥ 70 mg/L (HR: 13.2; P = .004) were the only factors independently associated with time to first treatment (TTFT). A risk model including these variables identified patients with 0, 1, and 2 risk factors and significantly different TTFT (P < .001). Patients with two factors represented an ultra‐high‐risk group with a median TTFT of only 1.3 months. Conclusion The above findings demonstrate the potential for the use of HLC immunoparesis, together with sFLC measurements, as future prognostic biomarkers in CLL.

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Within-subject biological variation of pairs of heavy/light immunoglobulin IgM chains (HLC IgM κ and λ) is low and requires monitoring: A comparison with HLC IgA, HLC IgG, and free light immunoglobulin chains (FLC) in healthy subjects

Jabor

Kubíček

Komrsková

et al. 2018

Clinica Chimica Acta

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Heavy/light chain assay as a biomarker for diagnosis and follow-up of multiple myeloma

Cited by 8 publications

References 15 publications

The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach

The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach

A new risk model to predict time to first treatment in chronic lymphocytic leukemia based on heavy chain immunoparesis and summated free light chain

Within-subject biological variation of pairs of heavy/light immunoglobulin IgM chains (HLC IgM κ and λ) is low and requires monitoring: A comparison with HLC IgA, HLC IgG, and free light immunoglobulin chains (FLC) in healthy subjects

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