PMID- 15774572
OWN - NLM
STAT- MEDLINE
DCOM- 20050607
LR  - 20190722
IS  - 0009-9147 (Print)
IS  - 0009-9147 (Linking)
VI  - 51
IP  - 5
DP  - 2005 May
TI  - Diagnostic performance of quantitative kappa and lambda free light chain assays 
      in clinical practice.
PG  - 878-81
AB  - BACKGROUND: The quantitative assay for free light chains (FLCs) is a recently 
      introduced commercial test reported to be sensitive and specific for detecting 
      FLC diseases such as primary systemic amyloidosis (AL), light chain deposition 
      disease (LCDD), nonsecretory multiple myeloma (NSMM), and light chain multiple 
      myeloma. We evaluated its diagnostic performance in clinical practice. METHODS: 
      All FLC clinical test results generated in 2003 were abstracted from the 
      Laboratory Information System. Diagnoses were obtained from the Dysproteinemia 
      database and the patient medical history. RESULTS: In 2003, we received samples 
      for FLC assays from 1020 Mayo Clinic patients. The majority of these patients 
      (88%) had bone marrow-derived monoclonal plasma cell disorders (PCDs). The 121 
      patients who did not have monoclonal gammopathy all had FLC kappa/lambda ratios 
      within the range of values obtained for a reference population in our laboratory. 
      Among the patients with monoclonal gammopathies were patients with multiple 
      myeloma (330), AL (269), monoclonal gammopathy of undetermined significance 
      (114), smoldering multiple myeloma (72), plasmacytoma (22), NSMM (20), 
      macroglobulinemia (9), LCDD (7), and a variety of other PCDs. Among the 110 AL 
      patients who had not been previously treated and who had a FLC assay performed 
      within 120 days of diagnosis, the FLC kappa/lambda ratio was positive in 91% 
      compared with 69% for serum immunofixation electrophoresis (IFE) and 83% for 
      urine IFE. The combination of serum IFE and serum FLC assay detected an abnormal 
      result in 99% (109 of 110) of patients with AL. CONCLUSION: The performance of 
      the FLC assay in this analysis of clinical laboratory data is consistent with 
      results from published retrospective validation studies.
FAU - Katzmann, Jerry A
AU  - Katzmann JA
AD  - Division of Clinical Biochemistry and Immunology, Department of Laboratory 
      Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905, 
      USA. katzmann@mayo.edu
FAU - Abraham, Roshini S
AU  - Abraham RS
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
FAU - Lust, John A
AU  - Lust JA
FAU - Kyle, Robert A
AU  - Kyle RA
LA  - eng
GR  - CA62242/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20050317
PL  - England
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
RN  - 0 (Immunoglobulin kappa-Chains)
RN  - 0 (Immunoglobulin lambda-Chains)
SB  - IM
CIN - Clin Chem. 2005 May;51(5):805-7. PMID: 15855664
MH  - Amyloidosis/*diagnosis
MH  - Clinical Laboratory Information Systems
MH  - Humans
MH  - Immunoglobulin kappa-Chains/*blood
MH  - Immunoglobulin lambda-Chains/*blood
MH  - Laboratories, Hospital
MH  - Medical Records Systems, Computerized
MH  - Multiple Myeloma/diagnosis
MH  - Paraproteinemias/*diagnosis
MH  - Plasmacytoma/diagnosis
MH  - Waldenstrom Macroglobulinemia/diagnosis
EDAT- 2005/03/19 09:00
MHDA- 2005/06/09 09:00
CRDT- 2005/03/19 09:00
PHST- 2005/03/19 09:00 [pubmed]
PHST- 2005/06/09 09:00 [medline]
PHST- 2005/03/19 09:00 [entrez]
AID - clinchem.2004.046870 [pii]
AID - 10.1373/clinchem.2004.046870 [doi]
PST - ppublish
SO  - Clin Chem. 2005 May;51(5):878-81. doi: 10.1373/clinchem.2004.046870. Epub 2005 
      Mar 17.