Is accuracy of serum free light chain measurement achievable?

Joannes F M Jacobs, Jillian R. Tate, Giampaolo Merlini

Research output: Contribution to journalArticlepeer-review


The serum free light chain (FLC) assay has proven to be an important complementary test in the management of patients with monoclonal gammopathies. The serum FLC assay has value for patients with plasma cell disorders in the context of screening and diagnosis, prognostic stratification, and quantitative monitoring. Nonetheless, serum FLC measurements have analytical limitations which give rise to differences in FLC reporting depending on which FLC assay and analytical platform is used. As the FLC measurements are incorporated in the International Myeloma Working Group guidelines for the evaluation and management of plasma cell dyscrasias, this may directly affect clinical decisions. As new certified methods for serum FLC assays emerge, the need to harmonise patient FLC results becomes increasingly important. In this opinion paper we provide an overview of the current lack of accuracy and harmonisation in serum FLC measurements. The clinical consequence of non-harmonized FLC measurements is that an individual patient may or may not meet certain diagnostic, prognostic, or response criteria, depending on which FLC assay and platform is used. We further discuss whether standardisation of serum FLC measurements is feasible and provide an overview of the steps needed to be taken towards harmonisation of FLC measurements.

Original languageEnglish
Pages (from-to)1021-1030
Number of pages10
JournalClinical Chemistry and Laboratory Medicine
Issue number6
Publication statusPublished - Jun 1 2016


  • free light chains
  • harmonisation
  • M-protein
  • monoclonal gammopathy
  • plasma cell dyscrasia
  • standardisation

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical


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