Contributions
Type: Publication Only
Background
Background: Monoclonal Gammopathies are characterized by the presence of a serum monoclonal component (MC), either an intact immunoglobulin, a free light chain, or a combination of both. Measurement of FLC with Freelite® is standard practice and it is recommended by IMWG guidelines. Recently, Hevylite™ heavy light chains (HLC) assays were introduced to specifically target junctional epitopes between the heavy and light chains of intact immunoglobulins, allowing the independent quantification of the involved Monoclonal Component and uninvolved, polyclonal background.
Aims
Aims: In our Department we have used FLC and HLC for diagnosis and monitoring of Monoclonal Gammopathies, particularly in Multiple Myeloma patients this method is useful for monitoring of disease.
Methods
Methods: from January 2012 to March 2014 we collected 300 samples from 90 patients and assessed the diagnostic and monitoring performance of Hevylite® A and G assays in 7 transplanted patients, 17 non eligible patients and 18 relapsing patients, receiving a combination therapy with VTD; PAD; MPV or Len/Dexa. We selected 3 emblematic case studies
Results
Results: Hevylite® absolute values and ratio demonstrated high sensitivity and specificity with respect to Freelite and serum protein electrophoresis, serum immunofixation. The combined use of Hevylite® A and G with Freelite® was particularly useful in dubious cases with more than one MC or with co-migrating components, and in the course of monitoring to assess the independent change of FLC and HLC, possibly reflecting the presence of clonal heterogeneity in our cohort.
Summary
Conclusions
Freelite and Hevylite are independent, useful markers to monitor the MC and to assess with greater specificity and sensibility the effect of therapy, thereby providing clinical support. More studies are needed to assess the prognostic potential of Hevylite in SMM and MGUS patients.
Type: Publication Only
Background
Background: Monoclonal Gammopathies are characterized by the presence of a serum monoclonal component (MC), either an intact immunoglobulin, a free light chain, or a combination of both. Measurement of FLC with Freelite® is standard practice and it is recommended by IMWG guidelines. Recently, Hevylite™ heavy light chains (HLC) assays were introduced to specifically target junctional epitopes between the heavy and light chains of intact immunoglobulins, allowing the independent quantification of the involved Monoclonal Component and uninvolved, polyclonal background.
Aims
Aims: In our Department we have used FLC and HLC for diagnosis and monitoring of Monoclonal Gammopathies, particularly in Multiple Myeloma patients this method is useful for monitoring of disease.
Methods
Methods: from January 2012 to March 2014 we collected 300 samples from 90 patients and assessed the diagnostic and monitoring performance of Hevylite® A and G assays in 7 transplanted patients, 17 non eligible patients and 18 relapsing patients, receiving a combination therapy with VTD; PAD; MPV or Len/Dexa. We selected 3 emblematic case studies
Results
Results: Hevylite® absolute values and ratio demonstrated high sensitivity and specificity with respect to Freelite and serum protein electrophoresis, serum immunofixation. The combined use of Hevylite® A and G with Freelite® was particularly useful in dubious cases with more than one MC or with co-migrating components, and in the course of monitoring to assess the independent change of FLC and HLC, possibly reflecting the presence of clonal heterogeneity in our cohort.
Summary
Conclusions
Freelite and Hevylite are independent, useful markers to monitor the MC and to assess with greater specificity and sensibility the effect of therapy, thereby providing clinical support. More studies are needed to assess the prognostic potential of Hevylite in SMM and MGUS patients.