Borderline High Serum Free Light Chain κ/λ Ratios Are Seen Not Only in Dialysis Patients but Also in Non–Dialysis-Dependent Renal Impairment and Inflammatory States

Marshall, George A.; Tate, Jill; Mollee, Peter

doi:10.1309/ajcp8vot5tvlaqbq

Cited by 13 publications

(7 citation statements)

References 2 publications

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“…In two patients, the abnormal FLC ratio coincided with an intercurrent infection and was of short duration. Besides infection, other inflammatory states and, occasionally, renal impairment could lead to abnormal light chain ratios (Marshall et al , ).…”

Section: Discussionmentioning

confidence: 99%

Potential pitfalls of serum free light chain analysis to assess treatment response for multiple myeloma

et al. 2016

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Response to treatment in patients with a plasma cell disorder is typically measured by evaluating the bone marrow and myeloma markers, including monoclonal protein spike and immunofixation (IFE) in blood and urine, and serum free light chains (sFLCs). Stringent complete response criteria for Multiple Myeloma (MM) patients require a normal FLC ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence. We performed a retrospective chart review to further evaluate these criteria. A total of 142 patient charts were analysed. Of these, 17 patients were found to have an abnormal sFLC ratio, but no other evidence of disease, including normal flow cytometry and normal fluorescence in situ hybridization (FISH) analysis on highly selected plasma cells. In all patients, the abnormal sFLC ratio was caused by abnormalities in the serum kappa light chains. These results suggest that current definitions may need to be revised to take aberrancies related to abnormal immune recovery into account.

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Section: Discussionmentioning

confidence: 99%

Potential pitfalls of serum free light chain analysis to assess treatment response for multiple myeloma

et al. 2016

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“…0.26–1.65 (100% interval)] was different from a group of patients (disease and age unknown, but without monoclonal gammopathy and renal impairment): 0.29–2.37 (100% interval). An underlying (inflammatory) disease with polyclonal hypergammaglobulinaemia (both kappa and lambda increased) might result in a slight increase of the ratio . Altogether, our κ/λ free light chain ratio reference range of 0.56–1.86 established in a patient group might be different from a healthy control population due to differences in age and underlying inflammatory state.…”

Section: Resultsmentioning

confidence: 63%

Diagnostic reference range of κ/λ free light chain ratio to screen for Bence Jones proteinuria is not significantly influenced by GFR

Schmidt-Hieltjes

Elshof

Roovers

et al. 2015

European J of Haematology

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A κ/λ free light chain ratio in serum can be used safely and efficiently to select urine samples which should be analysed for Bence Jones proteinuria with an electrophoresis/immunofixation technique. Using this diagnostic reference range, the number of urine samples which should be analysed by electrophoresis/immunofixation could be reduced by 74%. The diagnostic reference interval can be determined best in a group of patients for whom Bence Jones analysis is indicated. For calculation of this reference range, the eGFR value does not need to be taken into account.

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“…Polyclonal rise of cFLC predominantly reflects activation and proliferation of B-lymphocytes, although it could be also secondary to their impaired removal by dysfunctional kidneys or reticulo-endothelial system. [13,14] Elevation of polyclonal cFLC has been reported in inflammatory and autoimmune disorders, diabetes mellitus and chronic kidney disease. [15][16][17][18] Also, high cFLC concentrations are associated with activity of autoimmune disorders characterised by B-cell activation, with clearly distinct kinetics for cFLC and a C-reactive protein (CRP), a marker predominantly related to inflammatory responses of innate immunity.…”

Section: Introductionmentioning

confidence: 99%

Free Light Chains in patients with acute coronary syndromes: Relationships to inflammation and renal function

Shantsila¹,

Tapp²,

Lip³

2015

International Journal of Cardiology

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Borderline High Serum Free Light Chain κ/λ Ratios Are Seen Not Only in Dialysis Patients but Also in Non–Dialysis-Dependent Renal Impairment and Inflammatory States

Cited by 13 publications

References 2 publications

Potential pitfalls of serum free light chain analysis to assess treatment response for multiple myeloma

Potential pitfalls of serum free light chain analysis to assess treatment response for multiple myeloma

Diagnostic reference range of κ/λ free light chain ratio to screen for Bence Jones proteinuria is not significantly influenced by GFR

Free Light Chains in patients with acute coronary syndromes: Relationships to inflammation and renal function

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