The cut-offs for kappa/lambda ratio in bone marrow immunohistochemistry for the diagnosis of multiple myeloma

Treetipsatit, Jitsupa; Limvorapitak, Wasithep

doi:10.1080/16078454.2020.1802929

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Median Serum creatinine of 1.7 mg/dL was detected in the present study which was about the same result 1.7 ± 2.1 detected by Udupa et al, 2020 [ 2 ]. Renal impairment (serum creatinine > 2 mg/dL) in our study was detected in 38.3% of patients but a lower ratio was detected in 2020 by both Khallaf et al and Warnnissorn et al [ 15 , 16 ]. The higher ratio of renal impairment in this study may be attributed to the higher ratio of renal failure among Africans as stated by an African study in 2018 by Cisse et al [ 17 ].…”

Section: Discussioncontrasting

confidence: 53%

Clonal heterogeneity by fluorescence in situ hybridization in multiple myeloma: enhanced cytogenetic risk stratification

Abdel-Qader

Fouad

Abuelela

et al. 2022

Egypt J Med Hum Genet

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Background Multiple myeloma (MM) is a proliferation of monoclonal plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. Cytogenetic analysis is a challenge in MM because of the low mitotic activity and the rapid loss of plasma cells viability in bone marrow culture. Adding mitogens such as interleukin 6 (IL6) is known to promote the in vitro growth of myeloma cell lines and enhance the fluorescence in situ hybridization application. This study aims to evaluate the prognostic impact of cytogenetic abnormalities detected by enhanced interphase fluorescence in situ hybridization (iFISH) technique in Egyptian MM patients. Results Patients who had hyperdiploidy significantly presented with higher Hb level and lower calcium levels compared to non-hyperdiploid patients. They were staged as stage I and II by International staging system (ISS) and considered as standard risk showing better response to treatment. On the contrary, features associated with a worse outcome were patients having del 17p and those belonged to intermediate and high risk groups. Conclusion In conclusion, adding interleukin 6 to MM cell culture promotes the in vitro growth of myeloma cells and enhances the successful application of FISH technique. A comprehensive FISH probe set investigating high, intermediate and low-risk cytogenetic abnormalities is needed for accurate risk stratification. Hyperdiploid-myeloma is a favorable risk genetic subtype of MM associated with rapid response to therapy compared to patients having del 17p, t(4;14), and other 14q rearrangements rather than t(11;14) and t(6;14).

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Section: Discussioncontrasting

confidence: 53%

Clonal heterogeneity by fluorescence in situ hybridization in multiple myeloma: enhanced cytogenetic risk stratification

Abdel-Qader

Fouad

Abuelela

et al. 2022

Egypt J Med Hum Genet

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“…Therefore, early detection of M protein will improve the prognosis of patients with M-proteinemia (Wang et al, 2023). Kappa/lambda ratio (K/L) cut-offs of ≤ 1/7 and ≥ 9 have yielded the highest diagnostic accuracy for multiple myeloma (Warnnissorn et al, 2020). However, there has been limited research on the serum K/L value as an early warning of M-proteinemia (Landgren et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Early warning values of the kappa/lambda ratio based on serum detection for M-proteinemia diagnosis

Lu,

Zhu,

Huang

et al. 2024

Preprint

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Objective To introduce the kappa/lambda ratio (K/L) to humoral immunity testing reports to improve the detection rate of M-proteinemia disease. Method Patient samples were accumulated from January 2021 to December 2023 in the First Affiliated People’s Hospital of Soochow University. The positive control group included 156 patients of M-proteinemia. These samples were classified according to light chain positivity. The negative group included samples from 4,722 patients with non-plasma-cell monoclonal disease and 742 healthy individuals. Receiver operating characteristic (ROC) curves were used to check the reliability of K/L for M-proteinemia diagnosis. Results For K-type M-proteinemia, the area under the curve (AUC) was 0.932 when K/L was > 2.39, with a sensitivity of 87.3% and specificity of 92.3%. False positives were mainly found in samples with sicca syndrome (16.67%), mantle cell lymphoma (20.37%), and hepatitis (16.0%). For L-type M-proteinemia, when K/L < 1.44, the AUC was 0.863, the sensitivity was 72.9%, and the specificity was 88.8%. The false positives were mainly found in samples with ANCA-associated systemic vasculitis (21.88%), angioimmunoblastic lymphadenopathy–like T-cell lymphoma (31.25%), NK-/T-cell lymphoma (17.39%), T-cell lymphoma (11.11%), systemic lupus erythematosus (16.83%), cirrhosis (15.69%), infection (12.69%), systemic sclerosis (20.93%), and dermatomyositis (13.95%). False negatives were mainly found in AL (52.0%) and ML (36.36%) . Conclusion K/L > 2.39 and K/L < 1.44 should be used as warning values for M-proteinemia. The content of the heavy chain in IgA- or IgM-type M-proteinemia must be considered to improve the detection rate.

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“…Due to the monoclonal nature, the neoplasm produces either kappa (κ) or lambda light (λ) chain [22,23]. Certain light chain proteins are prone to form amyloidosis of AL (amyloid light chain) type [24].…”

Section: Introductionmentioning

confidence: 99%

Decrease of CD38 expression is linked to increase of solitary plasmacytoma pathological grade: a single institution experience from China

Li¹,

Guo²,

Yang³

et al. 2022

Front. Biosci. (Landmark Ed)

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Introduction: Solitary plasmacytoma (SP) is a rare plasma cell disorder characterized by localized neoplastic proliferation of monoclonal plasma cell. Due to its rarity, further understanding of the spectrum of its clinicopathologic features is needed. Methods: A retrospective analysis of cases from a single institution was conducted. Clinical characteristics of the patients were collected; histopathological and semi-quantitative immunohistochemical analyses were performed. Results: Thirteen cases were identified from our pathology archives, including 4 cases of solitary plasmacytoma of bone (SPB) (30.8%) and 9 extraosseous plasmacytoma (EP) (69.2%). The mean age of EP is a decade older than SPB. There is no gender disparity. The most common sites involved are the vertebrae and nasopharynx. Histologically, the tumors can be classified into two grades based on degree of differentiation. Immunohistochemically the tumor cells express CD38, CD138, MUM-1, and exhibit light chain restriction. Ki-67 proliferation index is 30%. In situ hybridization for Epstein-Barr virus-encoded small RNAs (EBER) is negative in six cases tested. Semi-quantitative immunohistochemical analysis showed decreased integrated optical density (IOD) of CD38 in neoplastic cells. IgH gene rearrangement was identified in two cases. Conclusion: SP is a rare plasmacytoid neoplasm that occurs more frequently in older patients. Diagnosis requires a systematic clinical approach combined with the pathological characteristics of plasmacytoid morphology, immunophenotype and light chain restriction. There are more cases of EP than SPB in our series, which is in contrast to that reported in literature. Results from this study suggest that CD38 is a potential immunohistochemical marker associated with prognosis of SP. Further studies with more cases and longer term follow-up may provide more definitive information on risk of progression from SP to multiple myeloma (MM).

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The cut-offs for kappa/lambda ratio in bone marrow immunohistochemistry for the diagnosis of multiple myeloma

Cited by 9 publications

References 10 publications

Clonal heterogeneity by fluorescence in situ hybridization in multiple myeloma: enhanced cytogenetic risk stratification

Clonal heterogeneity by fluorescence in situ hybridization in multiple myeloma: enhanced cytogenetic risk stratification

Early warning values of the kappa/lambda ratio based on serum detection for M-proteinemia diagnosis

Decrease of CD38 expression is linked to increase of solitary plasmacytoma pathological grade: a single institution experience from China

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