Intact Immunoglobulin Multiple Myeloma

96% of IIMM Patients Have Abnormal Light Chain Concentrations or Kappa/Lambda Ratio1

Some 82% of patients with Multiple Myeloma produce a detectable monoclonal protein of intact immunoglobulin heavy chain type G, A, M, D or E and either light chain kappa or lambda. This paraprotein can be used as a serum marker for diagnosis and levels can be monitored during treatment to assess efficacy.
Measurement of serum free light chains with Freelite® has shown that 96% of patients with Intact Immunoglobulin Multiple Myeloma also have abnormal light chain concentration or abnormal kappa/lambda (κ/λ) ratios in addition to the intact immunoglobulin.1

 



Concentrations of serum free light chains in 314 patients with IgG Myeloma compared with 282 normal sera.

 

Concentrations of serum free light chains in 142 IgA, 36 IgD and 5 IgE Myeloma patients compared with 282 normal sera.

 

 

 
 

 

 

Monitoring of one of the 17 Myeloma patients using IgGκ and free κ. Electrophoresis gels are shown for each sample. CVAMP = cyclophosphamide, vincristine, adriamycin, melphalan, prednisolone. HDM = high dose melphalan and stem cell transplant.1

Monitoring with Freelite® is useful in the assessment of tumor response to effective therapy because free light chain concentrations may decrease more rapidly due to their shorter half-life (hours) compared to intact immunoglobulins that have a longer half-life (days to weeks).

In a study of 493 patients with IIMM, 96% had abnormal free light chain concentrations (See figure above).1

Results of the comparison between serum free light chains, urine free light chains, serum immunofixation and bone marrow assessment. The number of patients who had abnormal bone marrows but normal urine FLC illustrates the increased sensitivity of serum FLC measurements.2

Bone Marrow
  Normal Abnormal
Serum Free Light Chains Normal 22 7
  Abnormal 10 66
 
Urine Free Light Chains Normal 25 31
  Abnormal 7 42
 
Serum Immunofixation Normal 14 6
  Abnormal 18 67


 

Freelite® is a valuable tool at all stages of patient management. It is useful when screening to support an initial diagnosis and can be used throughout treatment management as a reliable monitoring tool.

  1. Mead GP, et al. Serum free light chains for monitoring multiple myeloma. Br J Haematol 2004; 126:348-354
  2. Hobbs JR. Growth Rates and Responses to Treatment in Human Myelomatosis. Br J Haematol 1969; 16:607-617