Revista de Hematología

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>Journals >Revista de Hematología >Year 2015, Issue 2

Delgado F
Light chains: Total or free? Which ones should be measured
Rev Hematol Mex 2015; 16 (2)

Language: Español
References: 34
Page: 143-151
PDF: 476.26 Kb.

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Finding the most efficient diagnostic scheme that ensures the highest possible sensitivity and specificity for detection of monoclonal proteins in patients with multiple myeloma may present some controversy. This is the case of immunoassays for the quantification of light chains, which are still generating discussion although clinical endorsements are very strong. There are two types of assays commercially available currently that measure κ and λ light chains in serum. One type measures total (free and bound to heavy chains) light chains. The other type measures only free light chains. The current use of total light chain assay occurs in spite of international warnings that indicate the method is not sensitive enough for routine clinical use. Indeed, samples containing large amounts of free light chains may be completely missed using the total light chain technique. Different studies had compared the sensitivity between methods, both total and free light chain assays, in order to evaluate the clinical impact. The aim of this review article is to clarify some concepts about the foundations of the free light chain assay, distinguishing it from the total light chain assay and to compare the clinical utility of both tests.

Key words: immunoassays for serum light chains, multiple myeloma, diagnosis.


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