In the last decade, the introduction of the serum-free light-chain (sFLC) assay has been an important advance in the diagnosis and management of plasma cell dyscrasias, particularly monoclonal light-chain diseases. The immunoassay was developed to detect free light chains in serum by using anti-FLC antibodies which specifically recognised epitopes on light chains that were 'hidden' in intact immunoglobulins. Since its introduction in 2001, there have been several publications in the English language literature discussing the clinical utility as well as analytical limitations of the sFLC assay. These studies have highlighted both positive and negative aspects of the assay particularly with regard to its sensitivity and specificity and the technical challenges that can affect its performance. The contribution and significance of the sFLC assay in the management of light-chain myeloma, primary amyloid light-chain (AL) amyloidosis and non-secretory myeloma are well recognised and will be addressed in this review. The aim of this article is to also review the published literature with a view to providing a clear understanding of its utility and limitations in the diagnosis, prognosis and monitoring of plasma dyscrasias including intact immunoglobulin multiple myeloma (MM) and monoclonal gammopathy of unknown significance (MGUS). The increasing interest in using this assay in other haematological conditions will also be briefly discussed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/0004563213518758 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Serum free light chain level-based and non-fixed cycle daratumumab treatment strategy for patients with light chain amyloidosis.
Ann Med
December 2025
National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Background: In recent years, daratumumab (DARA) has gained widespread use in the treatment of systemic light chain (AL) amyloidosis. In this study, we assessed the efficacy and safety of a DARA treatment strategy based on serum free light chain (sFLC) levels and non-fixed cycles.
Methods: The study included 123 patients with Al amyloidosis who received DARA at our center between July 2020 and September 2023.
A Comparative Analysis of Freelite and N Latex FLC Assay for the sFLC Measurements in Suspected Patients of Monoclonal Gammopathy.
Indian J Hematol Blood Transfus
October 2024
Dept. of Hematology, SGPGIMS, Lucknow, India.
With the introduction of newer platforms for sFLC estimation, more comparative attempts are required to establish an assay-specific reference range, that can be used in the day-to-day clinical management of the patients, as the revised criteria for the diagnosis of myeloma recommend the use of involved Free light chain (FLC)/uninvolved FLC ratio as myeloma defining event, solely relying on Freelite assay. This was an observational study that included 101 patients, 55 (54.5%) with M-protein (myeloma), and 46 (45.
View Article and Find Full Text PDFArticle Synopsis
- Current guidelines suggest using serum M-protein and serum-free light chain analysis (S-FLC) for screening suspected M-protein-related disorders, as relying solely on serum M-protein might lead to missed cases of multiple myeloma.
- In some regions of Denmark, general practitioners are unable to order S-FLC tests, potentially affecting diagnosis.
- This review aims to educate on the importance, uses, and limitations of S-FLC analysis in identifying monoclonal gammopathies.
Serum-free light chains as a dependable biomarker for stratifying patients with metabolic dysfunction-associated steatotic liver disease.
Liver Int
October 2024
Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Background And Aims: Adaptive immunity is gaining a significant role in progression of metabolic dysfunction-associated steatotic liver disease (MASLD). B-cell activity can be assessed by serum-free light chains (sFLCs) k and λ levels. The objective of the present investigation is to examine the utility of sFLCs as non-invasive biomarkers for the stratification of MASLD.
View Article and Find Full Text PDFElevated polyclonal IgG4 mimicking a monoclonal gammopathy in IgG4-related disease-a case-based review.
Clin Rheumatol
September 2024
Functional Examination Room, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, #98 Nantong West Road, Yangzhou, 225001, China.
Article Synopsis
- IgG4-related diseases (IgG-RDs) involve inflammation that can cause organ damage and resemble tumors, with cases also seen alongside monoclonal gammopathies (MGPs) where abnormal plasma cell growth occurs.
- A 58-year-old man with diabetes presented symptoms like swollen lymph nodes and renal issues, leading to high levels of IgG4 and M protein detected through various lab tests.
- After ruling out other disorders via biopsies, he was diagnosed with IgG4-RD and diabetic nephropathy, showing significant improvement after treatment with rituximab and glucocorticoids.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!