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Clinical Chemistry and Laboratory Medicine (CCLM)

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Interlaboratory study of free monoclonal immunoglobulin light chain quantification

Jaroslava Vávrová1 / Vladimír Maisnar2, 3 / 1, 3 / Bedřich Friedecký1 / Zdeňka Čermáková4 / Milan Dastych4 / Jana Gottwaldová4 / Petr Kučera5 / Jarmila Krotká5 / Jaroslav Racek6 / Jana Ženková6 / Petr Schneiderka7 / Pavel Lochman7 / Tomáš Zima8 / Hana Benáková8 / Tomáš Büchler3, 9 / Jana Spáčilová1 / Roman Hájek3, 10 / Vladimír Palička1

1Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic

2Division of Clinical Haematology, 2nd Department of Medicine, Charles University Hospital, Hradec Kralove, Czech Republic

3Czech Myeloma Group, Czech Republic

4Department of Clinical Biochemistry and Haematology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic

5Department of Allergy and Clinical Immunology, Kralovske Vinohrady University Hospital, Prague, Czech Republic

6Institute of Clinical Biochemistry and Haematology, Charles University Medical School and University Hospital, Pilsen, Czech Republic

7Department of Clinical Biochemistry, Palacky University Hospital, Olomouc, Czech Republic

8Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University, Prague, Czech Republic

9Department of Oncology and 1st Faculty of Medicine, Thomayer University Hospital and Charles University, Prague, Czech Republic

10Babak Research Institute and Department of Internal Medicine and Hematooncology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic

Corresponding author: Prof. Miloš Tichý, Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, 500 05 Hradec Kralove, Czech Republic Phone: +420 495 832 274, Fax: +420 495 832 003

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 49, Issue 1, Pages 89–92, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2011.019, October 2010

Publication History

Received:
2010-03-10
Accepted:
2010-07-02
Published Online:
2010-10-30

Abstract

Background: Quantification of monoclonal immunoglobulin free light chains (FLCs) in serum is used increasingly in clinical practice for the diagnosis, prognostic assessment, and treatment monitoring of monoclonal gammopathies. It is used as an adjunct to standard serum protein electrophoresis and immunofixation. However, methods for FLC quantification need further standardization and validation.

Methods: The Czech Myeloma Group and the Czech Society of Clinical Biochemistry have initiated an interlaboratory study where six laboratories collaborating with the primary myeloma treatment centres measured FLC concentrations in 12 serum samples from patients with monoclonal gammopathies.

Results: Repeatability of the measurements in five laboratories was calculated based on differences between the results of duplicate measurements. We found that repeatability depended more on the laboratory than on the device used for measurement.

Conclusions: The study revealed several weak points in the methodology, including the need for a uniform sample dilution procedure. Interlaboratory reproducibility was comparable with values achieved in the NEQAS programme. Because the κ/λ ratio cannot be measured with high precision, κ and λ FLC concentrations should be used where possible. Due to its impact on the clinical management of patients with gammopathy, FLC quantification needs to become a part of the regular quality control cycle in myeloma centres.

Keywords: interlaboratory comparison; monoclonal free light chains; monoclonal gammopathy; multiple myeloma; standardisation

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