Monoclonal free light chain detection and quantification: Performances and limits of available laboratory assays

Sarto, Cecilia; Intra, Jari; Fania, Chiara; Brivio, Rinaldo; Brambilla, Paolo; Leoni, Valerio

doi:10.1016/j.clinbiochem.2021.05.006

Cited by 4 publications

(2 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the first commercially available serum FLC assay, Freelite, was launched by the Binding Site Ltd. (Birmingham, United Kingdom) in 2001, multiple other commercially available serum FLC assays have been released ( Table 1 ). Similar to the Freelite assay, the KLoneus assay, the Diazyme FLC assay and the Sebia FLC assay all use polyclonal antisera [ 47 , 48 , 49 ]. In contrast, the N-Latex FLC assay developed by Siemens and the Seralite assay developed by Abingdon Health both use monoclonal antisera [ 48 ].…”

Section: Laboratory Assays For the Detection And Measurement Of Monoc...mentioning

confidence: 99%

“…Similar to the Freelite assay, the KLoneus assay, the Diazyme FLC assay and the Sebia FLC assay all use polyclonal antisera [ 47 , 48 , 49 ]. In contrast, the N-Latex FLC assay developed by Siemens and the Seralite assay developed by Abingdon Health both use monoclonal antisera [ 48 ]. Polyclonal and monoclonal antisera have been shown to have differential affinities for monomers and dimers, which can lead to discrepant results being obtained between the assays.…”

Section: Laboratory Assays For the Detection And Measurement Of Monoc...mentioning

confidence: 99%

See 1 more Smart Citation

Performance Characteristics and Limitations of the Available Assays for the Detection and Quantitation of Monoclonal Free Light Chains and New Emerging Methodologies

Giles,

Karunanithi

2024

Antibodies

View full text Add to dashboard Cite

Light chain measurements form an essential component of the testing strategy for the detection and monitoring of patients with suspected and/or proven plasma cell disorders. Urine-based electrophoretic assays remain at the centre of the international guidelines for response assessment but the supplementary role of serum-free light chain (FLC) assays in response assessment and the detection of disease progression due to their increased sensitivity has been increasingly recognised since their introduction in 2001. Serum FLC assays have also been shown to be prognostic across the spectrum of plasma cell disorders and are now incorporated into risk stratification scores for patients with monoclonal gammopathy of undetermined significance (MGUS), smouldering multiple myeloma, and light chain amyloidosis (AL amyloidosis), as well as being incorporated into the criteria for defining symptomatic multiple myeloma. There are now multiple different commercially available serum FLC assays available with differing performance characteristics, which are discussed in this review, along with the implications of these for patient monitoring. Finally, newer methodologies for the identification and characterisation of monoclonal FLC, including modifications to electrophoretic techniques, mass spectrometry-based assays and Amylite, are also described along with the relevant published data available regarding the performance of each assay.

show abstract

Section: Laboratory Assays For the Detection And Measurement Of Monoc...mentioning

confidence: 99%

Section: Laboratory Assays For the Detection And Measurement Of Monoc...mentioning

confidence: 99%

Performance Characteristics and Limitations of the Available Assays for the Detection and Quantitation of Monoclonal Free Light Chains and New Emerging Methodologies

Giles,

Karunanithi

2024

Antibodies

View full text Add to dashboard Cite

show abstract

Serum soluble BCMA can be used to monitor relapse of multiple myeloma patients after chimeric antigen receptor T-cell immunotherapy

Shen

Liu

Wang

et al. 2023

Current Research in Translational Medicine

View full text Add to dashboard Cite

Clonality Determination by Detecting Unmodified Monoclonal Serum Free Light Chains Using On-Probe Extraction Coupled with Liquid Chromatography-High-Resolution Mass Spectrometry

Yeung,

Liu,

Yang

et al. 2024

Clinical Chemistry

View full text Add to dashboard Cite

Background Serum free light chains (FLCs) are an essential clinical biomarker for the diagnosis and monitoring of patients with plasma cell neoplasms. The current widely used immunoassay methods quantify total serum FLCs, which include monoclonal FLCs as well as FLCs in the polyclonal background. Patients with chronic diseases, inflammatory disorders, or renal dysfunction can have elevated total FLCs that lead to ambiguous results. These patients may benefit from a direct measurement of monoclonal FLCs. The purpose of this study was to develop a method that couples on-probe extraction (OPEX) with liquid chromatography-high-resolution mass spectrometry (LC-HR-MS), abbreviated to OPEX-MS, to directly determine the clonality of FLCs. Methods OPEX immunocapture was performed using microprobes loaded with anti-kappa or anti-lambda light chain antibodies. Captured proteins were separated by reversed-phase LC and analyzed by HR-MS. Results Four cohorts of samples from unique patients were tested based on immunoassay FLC results. The LC-HR-MS analysis in the OPEX-MS method provides both a unique retention time along with deconvoluted masses of FLC monomers and dimers for each clone. The study found that 16 out of 49 (33%) kappa FLC elevated samples as well as 83 out of 100 (83%) dual kappa and lambda FLC elevated samples did not have monoclonal FLCs, which is consistent with the knowledge that there is often no clonal population in samples with mildly elevated FLC immunoassay results. Conclusions The OPEX-MS method can serve as a complementary approach to directly determine clonality in patients with difficult-to-interpret FLC immunoassay results.

show abstract

Monoclonal free light chain detection and quantification: Performances and limits of available laboratory assays

Cited by 4 publications

References 47 publications

Performance Characteristics and Limitations of the Available Assays for the Detection and Quantitation of Monoclonal Free Light Chains and New Emerging Methodologies

Performance Characteristics and Limitations of the Available Assays for the Detection and Quantitation of Monoclonal Free Light Chains and New Emerging Methodologies

Serum soluble BCMA can be used to monitor relapse of multiple myeloma patients after chimeric antigen receptor T-cell immunotherapy

Clonality Determination by Detecting Unmodified Monoclonal Serum Free Light Chains Using On-Probe Extraction Coupled with Liquid Chromatography-High-Resolution Mass Spectrometry

Contact Info

Product

Resources

About