Concentrations of Serum Free Light Chains in Kappa and Lambda Lesions in Light-Chain Myelomas

Lab Med. 2019 Apr 8;50(2):189-193. doi: 10.1093/labmed/lmy067.

Abstract

Background: Concentration of serum free light chains has been promoted as an assay in the evaluation of monoclonal gammopathic manifestations. A high false-positive rate in patients without monoclonal gammopathic manifestations and a high false-negative rate in patients with those manifestations have been reported. The false-negative rate for lambda chain-associated lesions is higher than that for kappa chain-associated lesions.

Objective: To assess the serum free light chains in light-chain myelomas.

Methods: Concentrations of involved and uninvolved serum free light chains were retrospectively reviewed in patients with light-chain myelomas.

Results: The highest recorded levels of involved light chains in kappa-chain myelomas and lambda-chain myelomas were comparable. The levels of uninvolved light chains were higher, although not statistically significantly, in lambda-chain lesions.

Conclusions: The results of serum free light chains in light-chain myelomas support the clinical usefulness of the assay in monitoring patients with light chain myeloma.

Keywords: light-chain myeloma; monoclonal gammopathy; multiple myeloma; serum free light chains; serum protein electrophoresis; urine protein electrophoresis.

MeSH terms

  • Disease Progression
  • Electrophoresis / methods
  • Humans
  • Immunoglobulin kappa-Chains / analysis*
  • Immunoglobulin lambda-Chains / analysis*
  • Multiple Myeloma / blood*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / urine*
  • Retrospective Studies

Substances

  • Immunoglobulin kappa-Chains
  • Immunoglobulin lambda-Chains