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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Volume 49, Issue 1 (Jan 2011)

Issues

Interlaboratory study of free monoclonal immunoglobulin light chain quantification

Jaroslava Vávrová
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
/ Vladimír Maisnar
  • Division of Clinical Haematology, 2nd Department of Medicine, Charles University Hospital, Hradec Kralove, Czech Republic
  • Czech Myeloma Group, Czech Republic
/ Miloš Tichý
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
  • Czech Myeloma Group, Czech Republic
  • Email:
/ Bedřich Friedecký
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
/ Zdeňka Čermáková
  • Department of Clinical Biochemistry and Haematology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic
/ Milan Dastych
  • Department of Clinical Biochemistry and Haematology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic
/ Jana Gottwaldová
  • Department of Clinical Biochemistry and Haematology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic
/ Petr Kučera
  • Department of Allergy and Clinical Immunology, Kralovske Vinohrady University Hospital, Prague, Czech Republic
/ Jarmila Krotká
  • Department of Allergy and Clinical Immunology, Kralovske Vinohrady University Hospital, Prague, Czech Republic
/ Jaroslav Racek
  • Institute of Clinical Biochemistry and Haematology, Charles University Medical School and University Hospital, Pilsen, Czech Republic
/ Jana Ženková
  • Institute of Clinical Biochemistry and Haematology, Charles University Medical School and University Hospital, Pilsen, Czech Republic
/ Petr Schneiderka
  • Department of Clinical Biochemistry, Palacky University Hospital, Olomouc, Czech Republic
/ Pavel Lochman
  • Department of Clinical Biochemistry, Palacky University Hospital, Olomouc, Czech Republic
/ Tomáš Zima
  • Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University, Prague, Czech Republic
/ Hana Benáková
  • Institute of Clinical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University, Prague, Czech Republic
/ Tomáš Büchler
  • Czech Myeloma Group, Czech Republic
  • Department of Oncology and 1st Faculty of Medicine, Thomayer University Hospital and Charles University, Prague, Czech Republic
/ Jana Spáčilová
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
/ Roman Hájek
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
  • Czech Myeloma Group, Czech Republic
  • Babak Research Institute and Department of Internal Medicine and Hematooncology, Masaryk University Faculty of Medicine and University Hospital, Brno, Czech Republic
/ Vladimír Palička
  • Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Kralove, Czech Republic
Published Online: 2010-10-30 | DOI: https://doi.org/10.1515/CCLM.2011.019

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

About the article

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


Received: 2010-03-10

Accepted: 2010-07-02

Published Online: 2010-10-30

Published in Print: 2011-01-01


Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.019.

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©2011 by Walter de Gruyter Berlin New York. Copyright Clearance Center

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