Online ISSN: 2515-8260

Keywords : AL-amyloidosis

Role of free light chains as an addendum to protein electrophoresis in expediting multiple myeloma

Bhutesh Kumar Sharma, Dr. Girish Konasagara Shanthaveeranna

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2226-2230

Background: Multiple myeloma (MM) is a clonal plasma cell disorder with the hallmarks of bone marrow plasmacytosis and in most cases, production of an abnormal monoclonal immunoglobulin detectable in serum or urine protein electrophoresis. Assays that detect free light chain (FLC) are important in the diagnosis and monitoring of light chain only multiple myeloma (Bence Jones myeloma) and AL amyloidosis. Serum free light chain (sFLC) measured by scanning densitometry and electrophoresis lacks sensitivity in diagnosis and has a detection limit many times greater than the upper end of the normal range. Our study was done to know whether sFLC and their ratios can be used in diagnosis suspected cases of MM.
Methods: The study was conducted in a tertiary care hospital suspected of multiple myeloma. This is a descriptive analytical study involving subjects requested for Serum Protein Electrophoresis (SPE) and sFLC. Descriptive statistical analysis was carried out in the present study. To find out the association between the categorical studies variables we have used Chi square test. Pearson’s rank correlation is used to find the correlation between SPE results and sFLC.
Results: sFLC was able to diagnose 30 out of 33 subjects as multiple myeloma but 11 were diagnosed as false positive. When sFLC and SPE combined, all cases of multiple myeloma were diagnosed but false positive was high with 11 cases and none were diagnosed as false negative.
Conclusions: Combination of SPE and sFLC is more sensitive in identifying nearly all patients with clinically relevant monoclonal gammopathy.