IgA kappa/IgA lambda heavy/light chain assessment in the management of patients with IgA myeloma
Open Access
- 12 August 2014
- Vol. 120 (24), 3952-3957
- https://doi.org/10.1002/cncr.28946
Abstract
BACKGROUND Accurate quantification of immunoglobulin A (IgA) monoclonal immunoglobulins by serum protein electrophoresis (SPEP) can be difficult and can impact the assessment of response among patients with multiple myeloma (MM). Therefore, there is a need to identify new assays that better reflect disease burden and response to treatment, and correlate with patient outcome. IgA Hevylite (HLC) measures IgA kappa and IgA lambda separately and provides precise quantitative measurements of the monoclonal IgA expression and polyclonal‐isotype matched suppression. In the current study, the authors assessed the usefulness of these assays in the diagnosis of IgA MM and sought to comment on the prognostic value of the assays. METHODS A study of 157 patients with IgA MM for whom diagnostic samples were available was performed. HLC measurements were performed on a nephelometer and the results were compared with those of electrophoresis. RESULTS All presentation sera (100 IgA kappa specimens and 57 IgA lambda specimens) were found to have abnormal IgA HLC ratios (IgA kappa median ratio: 336.2 [range, 8.2‐7353] and IgA lambda ratio: 0.011 [range, 0.0003‐0.45]). In comparison, SPEP bands were quantifiable in only 105 of 157 samples (67%) (median, 28.5 g/L [range, 2.2 g/L‐98 g/L]). Of the total of 157 patients, 12 patients (8%) presented with oligosecretory myeloma (Cancer 2014;120:3952–3957. © 2014 American Cancer Society.Keywords
This publication has 12 references indexed in Scilit:
- Immunoglobulin heavy/light chain ratios improve paraprotein detection and monitoring, identify residual disease and correlate with survival in multiple myeloma patientsLeukemia, 2012
- Suppression of uninvolved immunoglobulins defined by heavy/light chain pair suppression is a risk factor for progression of MGUSLeukemia, 2012
- Prognostic utility of intact immunoglobulin Ig′κ/Ig′λ ratios in multiple myeloma patientsLeukemia, 2012
- Performance evaluation of the Helena V8 capillary electrophoresis systemClinical Biochemistry, 2012
- Long-Term Biological Variation of Serum Protein Electrophoresis M-Spike, Urine M-Spike, and Monoclonal Serum Free Light Chain Quantification: Implications for Monitoring Monoclonal GammopathiesClinical Chemistry, 2011
- Assessment of Monoclonal Gammopathies by Nephelometric Measurement of Individual Immunoglobulin κ/λ RatiosClinical Chemistry, 2009
- Quantitation of Serum Monoclonal Proteins: Relationship between Agarose Gel Electrophoresis and ImmunonephelometryClinical Chemistry, 2009
- Criteria for diagnosis, staging, risk stratification and response assessment of multiple myelomaLeukemia, 2008
- Performance Comparison of Capillary and Agarose Gel Electrophoresis for the Identification and Characterization of Monoclonal ImmunoglobulinsAmerican Journal of Clinical Pathology, 2008
- A retrospective study of the relative utility of electrophoresis, immunoelectrophoresis, immunofixation, and nephelometry in the investigation of serum proteinsClinical Biochemistry, 1996