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 Blood, 2 July 2009, Vol. 114, No. 1, pp. 38-39.
Prepublished online as a Blood First Edition Paper on May 1, 2009; DOI 10.1182/blood-2009-02-205807.

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CLINICAL TRIALS AND OBSERVATIONS

Brief report

The relationship between the serum free light chain assay and serum immunofixation electrophoresis, and the definition of concordant and discordant free light chain ratios

Seema Singhal1, Eric Vickrey1, Jairam Krishnamurthy1, Veerpal Singh1, Sharon Allen1, and Jayesh Mehta1

1 The Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL

"Stringent" complete remission in myeloma has been defined by a normal serum free light chain ratio (SFLCR) in addition to the standard criteria for CR. 2648 serial samples from 122 IgG or IgA myeloma patients were studied to explore the relationship between SFLCR and serum immunofixation electrophoresis (SIFE). SFLCR was normal in 34% of cases with positive SIFE and abnormal in 66%. SFLCR was normal in 69% of cases with negative SIFE and abnormal in 31%. When evaluated with SIFE as the benchmark, the sensitivity of SFLCR was 66% and specificity was 69%. These findings were unchanged when abnormal SFLCR values were classified as concordant (< 0.26 for {lambda} disease and > 1.65 for {kappa}) or discordant (< 0.26 for {kappa} disease and > 1.65 for {lambda}). Additional studies are required to determine the temporal relationship between SFLCR normalization and paraprotein clearance. Until then, the role of SFLCR in defining response remains controversial.


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Related Article in Blood Online:

Sensitivity of serum free light chain measurement of residual disease in multiple myeloma patients
Graham Peter Mead and Mark Trehane Drayson
Blood 2009 114: 1717. [Full Text] [PDF]



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G. P. Mead and M. T. Drayson
Sensitivity of serum free light chain measurement of residual disease in multiple myeloma patients
Blood, August 20, 2009; 114(8): 1717 - 1717.
[Full Text] [PDF]


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