International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders

Angela Dispenzieri, R. Kyle, G. Merlini, J. S. Miguel, H. Ludwig, R. Hajek, A. Palumbo, S. Jagannath, J. Blade, S. Lonial, M. Dimopoulos, R. Comenzo, H. Einsele, B. Barlogie, K. Anderson, M. Gertz, J. L. Harousseau, M. Attal, P. Tosi, P. SonneveldM. Boccadoro, G. Morgan, P. Richardson, O. Sezer, M. V. Mateos, M. Cavo, D. Joshua, I. Turesson, W. Chen, K. Shimizu, R. Powles, S. V. Rajkumar, B. G M Durie

Research output: Contribution to journalArticle

Abstract

The serum immunoglobulin-free light chain (FLC) assay measures levels of free κ and λ immunoglobulin light chains. There are three major indications for the FLC assay in the evaluation and management of multiple myeloma and related plasma cell disorders (PCD). In the context of screening, the serum FLC assay in combination with serum protein electrophoresis (PEL) and immunofixation yields high sensitivity, and negates the need for 24-h urine studies for diagnoses other than light chain amyloidosis (AL). Second, the baseline FLC measurement is of major prognostic value in virtually every PCD. Third, the FLC assay allows for quantitative monitoring of patients with oligosecretory PCD, including AL, oligosecretory myeloma and nearly two-thirds of patients who had previously been deemed to have non-secretory myeloma. In AL patients, serial FLC measurements outperform PEL and immunofixation. In oligosecretory myeloma patients, although not formally validated, serial FLC measurements reduce the need for frequent bone marrow biopsies. In contrast, there are no data to support using FLC assay in place of 24-h urine PEL for monitoring or for serial measurements in PCD with measurable disease by serum or urine PEL. This paper provides consensus guidelines for the use of this important assay, in the diagnosis and management of clonal PCD.

Original languageEnglish
Pages (from-to)215-224
Number of pages10
JournalLeukemia
Volume23
Issue number2
DOIs
Publication statusPublished - 2009

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Multiple Myeloma
Guidelines
Light
Plasma Cells
Serum
Electrophoresis
Amyloidosis
Immunoglobulin Light Chains
Urine
Proteins
Physiologic Monitoring
Blood Proteins
Bone Marrow
Biopsy

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. / Dispenzieri, Angela; Kyle, R.; Merlini, G.; Miguel, J. S.; Ludwig, H.; Hajek, R.; Palumbo, A.; Jagannath, S.; Blade, J.; Lonial, S.; Dimopoulos, M.; Comenzo, R.; Einsele, H.; Barlogie, B.; Anderson, K.; Gertz, M.; Harousseau, J. L.; Attal, M.; Tosi, P.; Sonneveld, P.; Boccadoro, M.; Morgan, G.; Richardson, P.; Sezer, O.; Mateos, M. V.; Cavo, M.; Joshua, D.; Turesson, I.; Chen, W.; Shimizu, K.; Powles, R.; Rajkumar, S. V.; Durie, B. G M.

In: Leukemia, Vol. 23, No. 2, 2009, p. 215-224.

Research output: Contribution to journalArticle

Dispenzieri, A, Kyle, R, Merlini, G, Miguel, JS, Ludwig, H, Hajek, R, Palumbo, A, Jagannath, S, Blade, J, Lonial, S, Dimopoulos, M, Comenzo, R, Einsele, H, Barlogie, B, Anderson, K, Gertz, M, Harousseau, JL, Attal, M, Tosi, P, Sonneveld, P, Boccadoro, M, Morgan, G, Richardson, P, Sezer, O, Mateos, MV, Cavo, M, Joshua, D, Turesson, I, Chen, W, Shimizu, K, Powles, R, Rajkumar, SV & Durie, BGM 2009, 'International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders', Leukemia, vol. 23, no. 2, pp. 215-224. https://doi.org/10.1038/leu.2008.307
Dispenzieri, Angela ; Kyle, R. ; Merlini, G. ; Miguel, J. S. ; Ludwig, H. ; Hajek, R. ; Palumbo, A. ; Jagannath, S. ; Blade, J. ; Lonial, S. ; Dimopoulos, M. ; Comenzo, R. ; Einsele, H. ; Barlogie, B. ; Anderson, K. ; Gertz, M. ; Harousseau, J. L. ; Attal, M. ; Tosi, P. ; Sonneveld, P. ; Boccadoro, M. ; Morgan, G. ; Richardson, P. ; Sezer, O. ; Mateos, M. V. ; Cavo, M. ; Joshua, D. ; Turesson, I. ; Chen, W. ; Shimizu, K. ; Powles, R. ; Rajkumar, S. V. ; Durie, B. G M. / International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. In: Leukemia. 2009 ; Vol. 23, No. 2. pp. 215-224.
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AU - Dispenzieri, Angela

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AU - Miguel, J. S.

AU - Ludwig, H.

AU - Hajek, R.

AU - Palumbo, A.

AU - Jagannath, S.

AU - Blade, J.

AU - Lonial, S.

AU - Dimopoulos, M.

AU - Comenzo, R.

AU - Einsele, H.

AU - Barlogie, B.

AU - Anderson, K.

AU - Gertz, M.

AU - Harousseau, J. L.

AU - Attal, M.

AU - Tosi, P.

AU - Sonneveld, P.

AU - Boccadoro, M.

AU - Morgan, G.

AU - Richardson, P.

AU - Sezer, O.

AU - Mateos, M. V.

AU - Cavo, M.

AU - Joshua, D.

AU - Turesson, I.

AU - Chen, W.

AU - Shimizu, K.

AU - Powles, R.

AU - Rajkumar, S. V.

AU - Durie, B. G M

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