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Clinical Chemistry and Laboratory Medicine (CCLM)

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

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2017: 3.556

CiteScore 2017: 2.34

SCImago Journal Rank (SJR) 2017: 1.114
Source Normalized Impact per Paper (SNIP) 2017: 1.188

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Volume 54, Issue 6


Free light chains and heavy/light chains in monitoring POEMS patients

Sara Altinier
  • Corresponding author
  • Department of Laboratory Medicine, University-Hospital of Padua, Via Giustiniani 2, 35128 Padova, Italy, Phone: +39 049 821 8708, Fax: +39 049 821 8489
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Kozeta Proko / Martina Zaninotto / Daniela Ciubotaru / Mara Seguso / Mariacristina Varagnolo / Federica Lessi / Chiara Briani / Fausto Adami / Mario PlebaniORCID iD: http://orcid.org/0000-0002-0270-1711
Published Online: 2016-04-12 | DOI: https://doi.org/10.1515/cclm-2015-0910


Background: POEMS syndrome is defined by Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes. The vascular endothelial growth factor (VEGF) appears to play a key role in the pathogenesis of the syndrome, and its concentrations are deemed to correlate to disease activity. The aim of the present study was to verify whether other biochemical markers including serum free light chains (FLC) and heavy/light chains (HLC) would be of value in monitoring POEMS patients.

Methods: Fifty-three serum samples were collected from seven POEMS patients at diagnosis and during a follow-up period (range 14–56 months). VEGF was measured using an ELISA method, while FLC and HLC concentrations were measured using Binding Site reagents on a BNII (Siemens) nephelometer.

Results: At diagnosis all patients presented high VEGF concentrations, while the κ/λFLC ratio (FLCr) was within the reference range. Four patients had abnormal HLC, HLCκ/HLCλ (HLCr) and FLC values. The relationship between the trend of VEGF and both HLC and FLC during the follow-up was analysed by means of Cohen’s κ coefficient. VEGF and HLC values displayed a significant κ-Cohen (0.537, p=0.002) in all chemotherapy-responder patients while in non-responders it did not. Conversely, in both responders and non-responders, VEGF and FLC values did not attain a significance on κ-Cohen analysis. In three out of four responders HLCr values increased, thus reflecting an improved clinical condition.

Conclusions: The findings made in the present study indicate that HLC, either as intact immunoglobulin or as HLCr, may provide useful information, particularly in identifying responders and confirm that the role of FLC is unreliable in monitoring patients with POEMS syndrome.

Keywords: free light chains; heavy/light chains; monoclonal gammopathy; POEMS syndrome; vascular endothelial growth factor


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About the article

Received: 2015-09-18

Accepted: 2016-03-02

Published Online: 2016-04-12

Published in Print: 2016-06-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 54, Issue 6, Pages 1065–1071, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2015-0910.

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