Diagnostic performance of serum free light chain measurement in patients suspected of a monoclonal B-cell disorder

British Journal of Haematology
Pieter VermeerschXavier Bossuyt

Abstract

The present study aimed to determine the diagnostic performance of different testing strategies to diagnose malignant B-cell disorder or monoclonal gammopathy of unknown significance (MGUS). Sensitivity and specificity were determined in 833 consecutive patients investigated for a monoclonal gammopathy. Serum protein electrophoresis (PE), serum kappa/lambda free light chain (FLC) ratio, and serum and urine immunofixation electrophoresis (IFE) were performed in all patients. Twenty-eight patients were diagnosed with a malignant plasma cell disorder, 25 with B-cell non-Hodgkin lymphoma and 156 with MGUS. Serum PE (with follow-up IFE) plus FLC had a sensitivity of 82.3% and a specificity of 96.8% and missed one plasmacytoma and 23 patients with MGUS. Serum IFE plus urine IFE had a sensitivity of 92.3% and a specificity of 100% and missed two MGUS patients. Serum IFE plus FLC had a sensitivity of 93.8% and a specificity of 96.8% and missed one MGUS patient. Serum PE plus FLC had a significantly lower sensitivity than serum IFE plus FLC or serum IFE plus urine IFE for the diagnosis of MGUS. The sensitivity of serum IFE plus FLC was comparable to the sensitivity of serum IFE plus urine IFE. The specificity of serum IFE plus FLC, howe...Continue Reading

References

Feb 14, 2003·Lancet·Arthur R BradwellMark T Drayson
Jan 18, 2006·British Journal of Haematology·Alastair SmithUNKNOWN British Committee for Standards in Haematology
Aug 31, 2006·Clinical Chemistry·Jerry A Katzmann
Oct 27, 2007·Annals of Clinical Biochemistry·Robert BeethamJacky A James
Mar 6, 2008·British Journal of Haematology·Guy Pratt

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Citations

Oct 29, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Richard HaynesPaul Cockwell
Sep 26, 2009·Clinica Chimica Acta; International Journal of Clinical Chemistry·Pieter VermeerschXavier Bossuyt
May 16, 2012·American Journal of Clinical Pathology·Khalil M CharafeddineRose T Daher
Sep 4, 2013·Clinica Chimica Acta; International Journal of Clinical Chemistry·Ellen Jenner

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