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Licensed Unlicensed Requires Authentication Published by De Gruyter September 2, 2020

Determination of free light chains: assay-dependent differences in interpretation

Xavier Bossuyt, Koen Poesen, Ben Sprangers, Martin Reynders, Martine Vercammen and Michel Delforge

Corresponding author: Xavier Bossuyt, Department of Microbiology, Immunology and Transplantation, Clinical and Diagnostic Immunology, KU Leuven, Leuven, Belgium; and Department of Laboratory Medicine, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium, Phone: +32 16 347009, Fax: +32 16 34 79 31, E-mail:

Acknowledgments

We thank Siemens and The Binding site for providing the reagents and for performing the assays.

We thank Carola Wagner, Oscar Berlanga, and Stephen Harding for helpful discussions. BS is a senior clinical investigator of The Research Foundation Flanders (F.W.O.) (1842919N).

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: BS has received an unrestricted research grant from The Binding Site.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was approved by the Ethics Committee of the University Hospitals Leuven and is in compliance with the World Medical Association Declaration of Helsinki.

References

1.. Katzmann, JA, Clark, RJ, Abraham, RS, Bryant, S, Lymp, JF, Bradwell, AR, et al. Serum reference intervals and diagnostic ranges for free kappa and free lambda immunoglobulin light chains: relative sensitivity for detection of monoclonal light chains. Clin Chem 2002;48:1437–44. https://doi.org/10.1093/clinchem/48.9.1437.Search in Google Scholar

2. te Velthuis, H, Knop, I, Stam, P, van den Broek, M, Bos, HK, Hol, S, et al. N Latex FLC - new monoclonal high-performance assays for the determination of free light chain kappa and lambda. Clin Chem Lab Med 2011;49:1323–32. https://doi.org/10.1515/cclm.2011.624.Search in Google Scholar

3. Cotten, SW, Shajani-Yi, Z, Cervinski, MA, Voorhees, T, Tuchman, SA, Korpi-Steiner, N. Reference intervals and diagnostic ranges for serum free κ and free λ immunoglobulin light chains vary by instrument platform: implications for classification of patient results in a multi-center study. Clin Biochem 2018;58:100–7. https://doi.org/10.1016/j.clinbiochem.2018.06.003.Search in Google Scholar

4. Bossuyt, X, Delforge, M, Reynders, M, Dillaerts, D, Sprangers, B, Fostier, K, et al. Diagnostic thresholds for free light chains in multiple myeloma depend on the assay used. Leukemia 2018;32:1815–18. https://doi.org/10.1038/s41375-018-0041-0.Search in Google Scholar

5. Jacobs, JF, Hoedemakers, RM, Teunissen, E, Te Velthuis, H. N Latex FLC serum free light-chain assays in patients with renal impairment. Clin Chem Lab Med 2014;52:853–9. https://doi.org/10.1515/cclm-2013-0864.Search in Google Scholar

6. Sprangers, B, Claes, K, Evenepoel, P, Kuypers, D, Poesen, K, Delforge, M, et al. Comparison of 2 serum-free light-chain assays in CKD patients. Kidney Int Rep 2020;5:627–31. https://doi.org/10.1016/j.ekir.2020.01.019.Search in Google Scholar

7. Tate, JR, Hawley, C, Mollee, P. Response to article by Caponi et al. about serum free light chains. Clin Chem Lab Med 2018;57:e1–2. https://doi.org/10.1515/cclm-2018-0994.Search in Google Scholar

8. Bossuyt, X, Delforge, M, Reynders, M, Dillaerts, D, Sprangers, B, Fostier, K, et al. Antigen excess detection by automated assays for free light chains. Clin Chem Lab Med 2018;56:e235–8. https://doi.org/10.1515/cclm-2017-0977.Search in Google Scholar

9. Vermeersch, P, Vercammen, M, Holvoet, A, Vande Broek, I, Delforge, M, Bossuyt, X. Use of interval-specific likelihood ratios improves clinical interpretation of serum FLC results for the diagnosis of malignant plasma cell disorders. Clin Chim Acta 2009;410:54–8. https://doi.org/10.1016/j.cca.2009.09.021.Search in Google Scholar

10. Rajkumar, SV, Kyle, RA, Therneau, TM, Melton, LJ3rd, Bradwell, AR, Clark, RJ, et al. Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. Blood 2005;106:812–7. https://doi.org/10.1182/blood-2005-03-1038.Search in Google Scholar


Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2020-0938).


Received: 2020-06-17
Accepted: 2020-08-04
Published Online: 2020-09-02
Published in Print: 2021-02-23

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