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Contribution of new immunoglobulin-derived biomarkers in plasma cell dyscrasias and lymphoproliferative disorders

World Journal of Hematology 2013年第2期2卷 6-12页

作者： Marie-Christine Kyrtsonis Dimitrios Maltezas Efstathios Koulieris Tatiana Tzenou Stephen J Harding Haematology Section of 1~(st) Department of Propaedeutic Internal Medicine Athens Medical SchoolLaikon University Hospital 11527 Athens Greece The Binding Site Group Ltd. BirminghamB151QT United Kingdom

New assays for serum immunoglobulin(Ig) free and heavy chain quantification were developed for routine clinical practice. Serum free light chain(s FLC) assay was shown to improve detection, management and prognostication in all plasma cell dyscrasias. More precisely, s FLC measurements proved to be prognostic for the progression of monoclonal gammopathy of undetermined significance and smoldering multiple myeloma(MM), became markers of response and survival in amyloid light-chain amyloidosis and contributed to accurate follow-up of patients with light chain and non secretory MM. In addition, s FLC and they ratio(s FLCR) were shown useful for the prognosis and monitoring of intact Ig myeloma; their evaluation was incorporated in the new uniform response criteria. s FLC or s FLCR were also observed abnormal in B-cell non-Hodgkin lymphoma/chronic lymphocytic leukemia(CLL). Moreover, increased s FLC levels, summated s FLC or abnormal s FLCR predict shorter overall survival in early-stage CLL while increased s FLC constituted an independent, adverseprognostic factor for event-free and overall survival in diffuse large B-cell lymphoma and Waldenstrom's macroglobulinemia. Clinical applications of heavy Ig chain separately(HLC) measurements are more recent and mainly concern MM in which HLC deriving ratios correlated with parameters of disease activity and constituted an adverse survival marker.

关键词： Immunoglobulin quantification freelitetm HevyliteTM Diagnosis Monitoring Prognosis

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