Role of Serum Free Light Chain Assay in Relapsed/Refractory Multiple Myeloma. A Real-Life Unicentric Retrospective Study

Markovic, Uroš; Romano, Alessandra; Bellofiore, Claudia; Condorelli, Angelo Giuseppe; Garibaldi, Bruno; Bulla, Anna; Duminuco, Andrea; Fabro, Vittorio Del; Raimondo, Francesco Di; Conticello, Concetta

doi:10.3390/cancers13236017

Cited by 2 publications

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References 21 publications

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“…SFLC has long become a valuable marker for diagnosing and monitoring light-chain MM, amyloid light-chain amyloidosis, and monoclonal gammopathies of undetermined signi cance (MGUS) (8-12). According to the IMWG diagnostic criteria, sFLC assay is recommended for disease surveillance in oligo-secretory and micromolecular MM (13).…”

Section: Discussionmentioning

confidence: 99%

Serum free light chains benefit diagnosis of multiple myeloma in orthopaedic patients with normal serum total proteins, creatinine, calcium and hemoglobin

Jia

Xia

2023

Preprint

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Background: A substantial number of MM patients with bone destruction are initially admitted into Orthopedics due to bone pain. However, routine laboratory tests usually fail to identify these patients and delay optimal therapy. Therefore, there is a clear medical need in early diagnose MM on these patient population. Methods Ninety-four orthopaedic patients were enrolled from July 2019 to December 2021. Of them, 42 patients were diagnosed as MM during postoperative pathology, but exhibited normal serum total proteins, creatinine, calcium and hemoglobin before operation. The rest 52 orthopaedic patients were pathologically excluded from MM and recruited into control group. The immunofixation electrophoresis (IFE) assays were performed to detect sFLC levels of all the subjects for comprehensively analyzed. Results The sFLC κ/λ ratios in 37 out of 42 MM patients were outside the reference range (0.31 ~ 1.56). All 42 MM patients were divided into two groups based on sFLC, κ/λ ratio > 1 or κ/λ < 1 respectively. And there were no significant differences in levels of serum total proteins, creatinine, calcium and hemoglobin between these two groups and control group. Conclusions This study highlighted the clinical significance of sFLC detection in early diagnosis of MM in orthopedics patients with unexplained bone destruction, supporting appropriate treatment choices preoperatively.

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Section: Discussionmentioning

confidence: 99%

Serum free light chains benefit diagnosis of multiple myeloma in orthopaedic patients with normal serum total proteins, creatinine, calcium and hemoglobin

Jia

Xia

2023

Preprint

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Urine immunofixation electrophoresis and serum free light chain analyses benefit diagnosis of multiple myeloma in orthopedic patients with normal serum total proteins, creatinine, calcium, and hemoglobin

Jia,

Xia,

2023

Laboratory Medicine

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Background A substantial number of patients with multiple myeloma (MM) who have bone destruction are initially admitted into the orthopedic service at the hospital. However, routine laboratory testing usually fails to identify these patients, thus delaying optimal therapy. Therefore, there is a clear medical need for early diagnosis of MM in these patients. Methods Between 2019 and 2021, 42 patients receiving treatment for orthopedic conditions had normal hemoglobin (Hb), total protein (TP), albumin (ALB), creatinine (CREA), and blood calcium (Ca) levels before their surgical procedure(s) but were subsequently pathologically confirmed to have MM, based on their presenting orthopedic symptoms. During the same period, 52 patients with orthopedic conditions were pathologically excluded from the diagnosis of MM and were recruited into our control group. Serum free light chain (sFLC) testing was performed in 94 consecutive patients in the orthopedic service using Siemens N Latex FLC kits. The levels of Hb, TP, ALB, CREA, and Ca were also measured. All 42 patients with MM were divided into group A (n = 25: κ proliferation) and group B (n = 17: λ proliferation) by the pathology department. Results There were no significant differences in levels of Hb, TP, ALB, CREA, and Ca between group A and group B and the control group. However, the sFLC κ/λ ratio of group A and B was also significantly different from that of the control group (P < .001). The results of serum immunofixation electrophoresis (IFE) testing demonstrated negative results in 14 cases (58.3%) in group A and 4 cases (25.0%) in group B. Conclusions Some patients with orthopedic conditions who do not have typical MM laboratory results, such as those with abnormal Hb, TP, ALB, CREA, and Ca levels before their operation(s), actually have MM. MM should be highly suspected in patients with unexplained bone lesions and with an abnormal sFLC κ/λ ratio. Further tissue or bone marrow biopsy is needed in these patients even if serum and urine IFE results are negative and light chain ratio is normal.

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Role of Serum Free Light Chain Assay in Relapsed/Refractory Multiple Myeloma. A Real-Life Unicentric Retrospective Study

Cited by 2 publications

References 21 publications

Serum free light chains benefit diagnosis of multiple myeloma in orthopaedic patients with normal serum total proteins, creatinine, calcium and hemoglobin

Serum free light chains benefit diagnosis of multiple myeloma in orthopaedic patients with normal serum total proteins, creatinine, calcium and hemoglobin

Urine immunofixation electrophoresis and serum free light chain analyses benefit diagnosis of multiple myeloma in orthopedic patients with normal serum total proteins, creatinine, calcium, and hemoglobin

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