Guidelines for the analysis of Bence Jones protein

Mariastella Graziani, Giampaolo Merlini, Concetta Petrini

Research output: Contribution to journalArticle

Abstract

The detection and quantification of monoclonal free light chains in urine (Bence Jones protein, BJP) are thorny issues for the laboratorian. Immunoelectrophoretic techniques (immunofixation) allow the characterization of the two pathognomonic features of light chains: monoclonality and absence of heavy chains. Immunochemical methods such as nephelometry and turbidimetry are widely used in clinical practice to exclude the presence of BJP. However, these methods are limited by several metabolic and analytical problems. The accuracy of quantitative immunochemical methods is hampered by the heterogeneous molecular forms (fragments and polymers) of BJP and by the lack of reference materials, and the precision of the methods in clinically relevant regions of the dynamic range is poorly defined. Immunoelectrophoretic methods, especially immunofixation, are recommended because of their ability to demonstrate monoclonality and the absence of heavy chains. Immunofixation is also considered the best method to document the disappearance of the monoclonal protein (complete remission). The physiology of immunoglobulins and the clinical relevance of BJP are illustrated in the two appendices to this paper.

Original languageEnglish
Pages (from-to)338-346
Number of pages9
JournalClinical Chemistry and Laboratory Medicine
Volume41
Issue number3
DOIs
Publication statusPublished - 2003

Keywords

  • Immunofixation
  • Monoclonal gammopathies
  • Monoclonal immunoglobulin light chains
  • Nephelometry
  • Turbidimetry

ASJC Scopus subject areas

  • Clinical Biochemistry

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