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Journal articles on the topic 'Kappa lambda ratio'

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Published: 5 June 2025
Last updated: 2 August 2025

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1

Ambrosino, D. M., M. V. Kanchana, N. R. Delaney, and R. W. Finberg. "Human B cells secrete predominantly lambda L chains in the absence of H chain expression." Journal of Immunology 146, no. 2 (1991): 599–602. http://dx.doi.org/10.4049/jimmunol.146.2.599.

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Abstract Ig H and L chains are independently assembled in B cells and then secreted together as a functional protein. H chains cannot be secreted without assembly to L chains; however, L chains can be secreted in the absence of H chains by both mice and human cells. To examine the influence of H chain expression on human L chain isotype selection (kappa or lambda), we compared the kappa/lambda ratio of L chains unassociated with H chains (free L chains) to the kappa/lambda ratio of L chains associated with H chains. Culture supernatants of human splenocytes were assayed for kappa and lambda L
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2

Saitta, M., A. Iavarone, N. Cappello, M. R. Bergami, G. C. Fiorucci, and F. Aguzzi. "Reference Values for Immunoglobulin Kappa and Lambda Light Chains and the Kappa/Lambda Ratio in Children's Serum." Clinical Chemistry 38, no. 12 (1992): 2454–57. http://dx.doi.org/10.1093/clinchem/38.12.2454.

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Abstract We analyzed 708 serum samples from healthy children and adolescents by immunonephelometry to obtain reference values for the immunoglobulin kappa (kappa) and lambda (lambda) light chains and for their ratio at a time of life when immunoglobulin synthesis is maturing and continually being stimulated. The lambda chain concentration that is to be maintained throughout the child's life is reached very early, just after 1 year, whereas the concentration of the kappa chains, which increases gradually, reflects the concentration of the immunoglobulins as a whole. These reference values may b
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3

Rajkumar, S. Vincent, Robert A. Kyle, Terry M. Therneau, et al. "Presence of an Abnormal Serum Free Light Ratio Is an Independent Risk Factor for Progression in Monoclonal Gammopathy of Undetermined Significance (MGUS)." Blood 104, no. 11 (2004): 3647. http://dx.doi.org/10.1182/blood.v104.11.3647.3647.

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Abstract Background: Monoclonal gammopathy of undetermined significance (MGUS) affects 3% of persons age 50 yrs or greater. Reliable predictors of progression of MGUS to myeloma or related malignancy are needed. We hypothesized that the presence of monoclonal unbound (free) kappa or lambda immunoglobulin light chains in MGUS, as detected by an abnormal serum kappa/lambda free light chain (FLC) ratio would indicate clonal evolution in the neoplastic plasma cell and increase risk of progression to malignancy. Methods: Patients (pts) from Southeastern Minnesota with MGUS seen at the Mayo Clinic f
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4

Levinson, Stanley S. "kappa/lambda index for confirming urinary free light chain in amyloidosis AL and other plasma cell dyscrasias." Clinical Chemistry 37, no. 6 (1991): 1122–26. http://dx.doi.org/10.1093/clinchem/37.6.1122.

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Abstract Primary systemic amyloidosis (AL), a disease involving the deposition of immunoglobulin light chains in tissue, is caused by a plasma cell dyscrasia. In the case of amyloidosis reported here, no monoclonal component was seen upon routine protein electrophoresis of serum or urine nor was a bone marrow analysis positive for AL. Immunofixation electrophoresis did not show a typical paraprotein band but did show, in the gamma region, two large diffuse bands and a lower concentration of oligoclonal-type bands, all of which stained for free lambda but not for free kappa chain. The ratio of
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5

Anand and Bharty Rolly. "A Study to Assess the Serum Free Light Chain Assay and Urine Protein Immunofixation in the Diagnosis of Patients with Monoclonal Gammopathy: A Retrospective Study." International Journal of Current Pharmaceutical Review and Research 16, no. 03 (2024): 539–43. https://doi.org/10.5281/zenodo.12792685.

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AbstractAim: The aim of the present study was to assess the serum free light chain assay and urine protein immunofixationin the diagnosis of patients with monoclonal gammopathy.Methods: The study included 22 patients, most of whom had monoclonal gammopathies and were hospitalizedat Jawaharlal Nehru Medical College, Bhagalpur, Bihar, India for one year.Results: The median age of the patients (13 men and 9 women) was 64 years. 3 patients were suffering only fromLCDD λ and 1 patient was suffering from non-secretory myeloma with FLC κ. 11 patients had multiple myeloma(6 with IgG &kapp
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6

Renckens, A. L., M. J. Jansen, P. J. van Munster, C. M. Weemaes, and J. A. Bakkeren. "Nephelometry of the kappa/lambda light-chain ratio in serum of normal and diseased children." Clinical Chemistry 32, no. 12 (1986): 2147–49. http://dx.doi.org/10.1093/clinchem/32.12.2147.

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Abstract We determined, immunonephelometrically, the ratio between the two types of light chains of immunoglobulins, kappa and lambda, in serum of 94 children, ages 0.4 to 14 years, with no manifest immunological disorders. Children with an abnormal protein pattern by immunoelectrophoresis show other values for this ratio than do children in this reference group. We also determined the ratios for children with IgA deficiency (I), juvenile rheumatic arthritis (II), and acute lymphoblastic leukemia (III). Children with I show the same kappa/lambda ratios as for the children in the reference grou
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7

Whicher, J. T., M. Wallage, and R. Fifield. "Use of immunoglobulin heavy- and light-chain measurements compared with existing techniques as a means of typing monoclonal immunoglobulins." Clinical Chemistry 33, no. 10 (1987): 1771–73. http://dx.doi.org/10.1093/clinchem/33.10.1771.

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Abstract Using automated measurements of kappa and lambda light chains and IgG, IgA, and IgM, we assessed the utility of the kappa/lambda ratio and the heavy chain/light chain ratio in characterizing monoclonal immunoglobulins previously identified by sensitive electrophoresis on agarose gel and typed by immunofixation or immunoelectrophoresis. We examined 348 selected samples, of which 165 contained monoclonal components, finding that 93.4% were detected and 89% correctly typed by this approach. Eight samples were shown to contain monoclonal light chains that were not visible as bands on elec
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8

Reeves, W. H., and S. A. Ali. "Preferential use of lambda L chain in lamin B autoantibodies." Journal of Immunology 143, no. 11 (1989): 3614–18. http://dx.doi.org/10.4049/jimmunol.143.11.3614.

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Abstract The generation of lamin B autoantibodies was examined in a patient with SLE. Lamin B autoantibodies in this individual's serum were almost entirely IgG1 lambda at the onset of the autoimmune response. There was no evidence of IgM to IgG class switching, and no apparent diversification of the autoantibody response over the next 2 yr. The kappa/lambda L chain ratio of the lamin B autoantibodies was 0.13 by ELISA, with a kappa/lambda ratio of 0.70 for the patient's total IgG. In contrast, anti-histone autoantibodies in the patient's serum contained primarily kappa L chain. The kappa/lamb
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9

Hungria, Vania T. M., Petros Kampanis, Mark T. Drayson, et al. "Comparison of Kappa & Lambda Freelite to Total Kappa & Lambda Immunoassays for the Detection of Monoclonal Gammopathies, Both As Standalone Tests and Alongside Serum Protein Electrophoresis." Blood 124, no. 21 (2014): 5705. http://dx.doi.org/10.1182/blood.v124.21.5705.5705.

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Abstract Introduction Monoclonal gammopathies are a disparate group of diseases from benign to malignant which are characterised by the proliferation of a single B cell clone that produces a homogeneous monoclonal immunoglobulin (M-Ig). The method of detection and quantification of the M-Ig will depend upon whether it is an intact immunoglobulin or present as serum free light chain only. Historically serum (SPEP) and urine (UPEP) electrophoresis were considered the gold standard for identifying intact M-Ig and FLC respectively. In 2001 the introduction of the Freelite test changed the diagnost
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10

Abbi, Kamal Kant Singh, Guido J. Tricot, Margarida Silverman, Kalyan Nadiminti, and Matthew Krasowski. "Potential Pitfalls of Serum Free Light Chain Analysis to Assess Treatment Response for Multiple Myeloma." Blood 126, no. 23 (2015): 5308. http://dx.doi.org/10.1182/blood.v126.23.5308.5308.

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Abstract Background The serum free light chain (FLC test) allows measurement of low concentrations of FLC. Post-transplantation, especially after tandem autologous transplants and consolidation therapy, the immune system is often extremely suppressed and its recovery is disorganized. Patients and Methods This study was limited to patients with multiple myeloma, plasma cell leukemia and amyloidosis, who received autologous transplantation and consolidation therapy at the University of Iowa Hospitals and clinics. Most of these patients had already received some form of induction therapy with IMI
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11

Ford, R. P., P. E. Mitchell, and C. G. Fraser. "Desirable performance characteristics and clinical utility of immunoglobulin and light-chain assays derived from data on biological variation." Clinical Chemistry 34, no. 9 (1988): 1733–36. http://dx.doi.org/10.1093/clinchem/34.9.1726.

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Abstract Using automated assays of IgG, IgA, and IgM, and kappa (kappa) and lambda (lambda) light-chains, we assessed the analytical, intra-individual, and interindividual components of variation in a cohort of 12 apparently healthy subjects to examine the utility of the Kallestad Immunochemical Evaluation system. The immunoglobulins and light-chains had small intra-individual variation, and, in consequence, good analytical precisions (CV) of 2.3%, 2.5%, 3.0%, 2.4%, and 2.4% are required for IgG, IgA, IgM, kappa, and lambda assays, respectively. All of these analytes, and the derived kappa/lam
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12

Herkner, K. R., H. Salzer, A. Böck, et al. "Pediatric and Perinatal Reference Intervals for Immunoglobulin Light Chains Kappa and Lambda." Clinical Chemistry 38, no. 4 (1992): 548–50. http://dx.doi.org/10.1093/clinchem/38.4.548.

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Abstract In routine analysis for immunoglobulin light chains in pediatric diagnostics, the age-related reference intervals for serum kappa (kappa) and lambda (lambda) light chains were evaluated in 1543 healthy subjects (newborns to age 16 years, including 168 premature infants). Light-chain analysis was performed by rate nephelometry. IgG, IgA, and IgM were measured simultaneously, and heavy- and light-chain differences were calculated for control purposes. Results for IgG, IgA, and IgM generally agreed with reference intervals reported in the literature. kappa showed age-related changes comp
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13

Burkly, L. C., J. Nikolic, and H. H. Wortis. "T cell regulation of light chain expression: preferential enhancement of Ig kappa in a primary thymus-dependent response does not require affinity-based selection." Journal of Immunology 135, no. 3 (1985): 1573–76. http://dx.doi.org/10.4049/jimmunol.135.3.1573.

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Abstract Previously we reported that the proportion of Ig kappa to Ig lambda anti-DNP antibodies produced by day 5 of a primary response to thymus-dependent antigens was fivefold greater than the Ig kappa:Ig lambda ratios found in responses to thymus-independent antigens. To determine whether an affinity-based process explained the differences in kappa/lambda ratios seen, we measured the affinity of Ig kappa and Ig lambda antibody by using the binding ratio radioimmunoassay method, which measures the affinity of antibodies of particular isotypes without the need for prior purification. By the
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14

Einarsson Long, Thorir, Sæmundur Rögnvaldsson, Sigrun Thorsteinsdottir, et al. "Revised Definition of Free Light Chains in Serum and Light Chain Monoclonal Gammopathy of Undetermined Significance: Results of the Istopmm Study." Blood 142, Supplement 1 (2023): 535. http://dx.doi.org/10.1182/blood-2023-188547.

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Background: Serum free light chain (FLC) measurement, consisting of serum free kappa, serum free lambda, and a calculated FLC ratio (kappa/lambda), plays a pivotal role in the diagnosis, risk stratification and management of plasma cell disorders. Light chain monoclonal gammopathy of undetermined significance (LC-MGUS), is defined as abnormal FLC ratio with elevation of the involved FLC without evidence of heavy chain M protein or end-organ damage attributed to the plasma cell disorder. Several years ago, reference intervals for serum kappa (3.3-19.4 mg/L) and lambda (5.7-26.3 mg/L) FLC and FL
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15

Šegulja, Dragana, Danica Matišić, Karmela Barišić, and Dunja Rogić. "Verification study of free light chains assays on reagent-optimized analysers." Biochemia medica 29, no. 3 (2019): 579–86. http://dx.doi.org/10.11613/bm.2019.030709.

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Introduction: Our aim was to compare analytical specifications of two assays (monoclonal vs. polyclonal) for free light chains (FLCs) quantification optimized for two different analytical platforms, nephelometer ProSpec (Siemens, Erlangen, Germany) and turbidimetric analyser Optilite (The Binding Site, Birmingham, UK). Materials and methods: The evaluation included verification of the precision, repeatability and reproducibility, estimation of accuracy and method comparison study with 37 serum samples of haematological patients. Kappa and lambda FLC were measured in each sample by both methods
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16

Ward, R. E., and H. Kohler. "Regulation of clones responding to dextran B1355S. III. The thymic-independent and thymic-dependent antibody responses." Journal of Immunology 134, no. 3 (1985): 1430–35. http://dx.doi.org/10.4049/jimmunol.134.3.1430.

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Abstract The primary antibody response of different mouse strains challenged with two antigenic forms of alpha (1-3) dextran, dextran B1355S and dextran-hemocyanin, was examined. Only BALB/c mice responded with both kappa and lambda antibodies. The kappa to lambda ratio was affected by factors such as the antigenic form of dextran, the time at which the serum was analyzed, and the priming regimen. Surprisingly, priming with hemocyanin in adjuvant increased the kappa portion of the response not only to dextran-hemocyanin but also to dextran B1355S. Other strains of mice responded with only lamb
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17

Engelhardt, Monika, Daniel Räpple, Andreas Weis, Emanuel Bisse, and Gabriele Ihorst. "Serum Free Light Chain (FLC) Measurement in Multiple Myeloma (MM) Patients (pts) Correlate with Known Monoclonal Paraprotein, Disease Stage and Therapy Response." Blood 104, no. 11 (2004): 4907. http://dx.doi.org/10.1182/blood.v104.11.4907.4907.

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Abstract So far, data based on small patient (pt) population suggest that the measurement of serum FLC from MM pts undergoing high-dose chemotherapy (HDCT) with stem cell transplantation (SCT) may be a sensitive marker for monitoring therapy success and for early detection of relapse. For further evaluation of the impact of FLCs on the assessment of treatment efficacy of standard- (ST) and HDCT with SCT, we performed a prospective analysis on serial serum specimens from 86 MM and 9 control pts. Measurement of FLC concentration was performed with the commercially available Freelite™ kit (Bindin
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18

Smith, David E., Jude Abadie, Daniel Bankson, and Graham Mead. "Assessment of Serum Free Light Chain Assay for Screening for Plasma Cell Disorders." Blood 106, no. 11 (2005): 2563. http://dx.doi.org/10.1182/blood.v106.11.2563.2563.

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Abstract Introduction and Methods: The purpose of this study was to evaluate the serum free light chain (FLC) assay in its ability to improve performance of protocols designed to screen for plasma cell disorders. We measured M-protein levels using serum protein electrophoresis (SPEP) in 312 consecutive patients being screened for plasma cell disorders at the Veterans Administration Medical Center - Puget Sound. The serum kappa and lambda free light chain levels were quantitated using the serum FLC assay in these same patients. The kappa/lambda ratio was calculated using the free kappa and free
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19

Bradwell, Arthur R., Jean Garbincius, and Earle W. Holmes. "Serum Free Kappa to Free Lambda Ratios as an Adjunct to Serum Protein Electrophoresis for the Detection of Monoclonal Proteins in the Serum." Blood 104, no. 11 (2004): 4856. http://dx.doi.org/10.1182/blood.v104.11.4856.4856.

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Abstract Serum free light chain measurements have been shown to be useful in the diagnosis and monitoring of patients with monoclonal gammopathies. The present study was undertaken to evaluate the effect of adding the measurement of serum free light chain kappa to lambda ratios to the serum protein electrophoresis evaluation that we typically use as an initial screen for the detection of monoclonal proteins. We retrospectively tested 347 consecutive samples from individuals who had no previous history of plasma cell dyscrasia and had not previously had a serum or urine electrophoresis or immun
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20

Taiwo, Evelyn, Huiying Wang, and Robert Lewis. "Treatment of Coexisting Chronic Neutrophilic Leukemia and Light Chain Multiple Myeloma with Hydroxyurea, Bortezomib, and Dexamethasone." Case Reports in Hematology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/869395.

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A 63-year-old female was incidentally found to have leukocytosis and referred to the hematology service for evaluation. Complete blood count (CBC) revealed neutrophilia with band predominance and mild thrombocytopenia. Peripheral blood flow cytometry was unremarkable without any evidence of lymphoproliferative disorder or myeloblasts. Bone marrow aspiration and biopsy revealed a markedly hypercellular marrow with myeloid lineage predominance and approximately 10% plasma cells. The monoclonal gammopathy was determined as lambda light chain with a kappa/lambda ratio of 0.06. Cytogenetics reveale
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21

Najarro, Gabriel, Vikas A. Gupta, Nisha S. Joseph, et al. "Serum Free Light Chain Ratio Is Inversely Proportional to the Egfr, and Has Been Increasing over the Last Decade." Blood 144, Supplement 1 (2024): 5142. https://doi.org/10.1182/blood-2024-202078.

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Background: Serum concentrations of FLC depend on plasma cell production and renal clearance. The reference range was defined from 127 healthy donors (21-62 years of age) and 155 patients 51-90 years of age (Katzmann JA et al, 2002, PMID 12194920) - kappa (3.3-19.4 mg/L), lambda (5.7-26.3 mg/L) and FLC ratio (0.26-1.65). The Iceland Screens, Treats, or Prevents MM (iStopMM) study analyzed 6,461 subjects with eGFR < 60 mL/min, proposing new reference intervals for the FLC ratio of 0.46-2.62, 0.48-3.38, and 0.54-3.30 for eGFR 45-59, 30-44, and < 30 mL/ min/1.73 m2 groups, respectiv
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22

Munda, Eliakim, Zachary French, and Ruben Rhoades. "Chronic Kidney Disease Impairs Predictive Ability of Serum Free Light Chain Ratio for Clonal Bone Marrow Plasma Cells in MGUS Patients." Blood 144, Supplement 1 (2024): 6879. https://doi.org/10.1182/blood-2024-204275.

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Introduction: Various models, including the Mayo Clinic model and iStopMM, aid in predicting which patients with monoclonal gammopathy of undetermined significance (MGUS) are likely to have or develop smoldering (SMM) or multiple myeloma (MM). Both models incorporate serum free light chain ratio (SFLCR) as a variable. Renal impairment is known to affect serum free light chains by raising free kappa, and may lessen the predictive ability of SFLCR for clonal bone marrow plasma cell (BMPC) percentage. Further, patients with CKD and kappa-involved MGUS may receive unnecessary bone marrow biopsies
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23

Chu, Samuel Y. "The use of kappa lambda ratio in the detection of serum paraprotein." Clinical Biochemistry 20, no. 4 (1987): 283–84. http://dx.doi.org/10.1016/s0009-9120(87)80016-4.

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24

Levi, F. A., C. Canon, J. P. Blum, M. Mechkouri, A. Reinberg, and G. Mathe. "Circadian and/or circahemidian rhythms in nine lymphocyte-related variables from peripheral blood of healthy subjects." Journal of Immunology 134, no. 1 (1985): 217–22. http://dx.doi.org/10.4049/jimmunol.134.1.217.

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Abstract Circadian variations were investigated for nine lymphocyte-related variables in the peripheral blood of healthy subjects. Monoclonal antibodies targeted at membrane immunoglobulins (anti-Ig, anti-kappa, anti-lambda) or differentiation antigens (anti-IA and OKT3) were used to characterize respectively mature B cells (SIg+, kappa +, lambda +), cells expressing HLA-DR antigen (IA+), and T cells (OKT3+). Blood (33 ml) was drawn every 4 hr for 24 hr starting at 8.30 hr, on seven occasions in five apparently healthy male volunteers, recumbent from 23.00 hr to 07.00 hr. Leukocyte and differe
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25

Kyrtsonis, Marie-Christine, Theodoros P. Vassilakopoulos, Nicoletta Kafasi, et al. "Serum Free Light Chain Ratio (FLCR) at Diagnosis Constitute a Powerful Prognostic Factor of Survival in Multiple Myeloma (MM)." Blood 108, no. 11 (2006): 3522. http://dx.doi.org/10.1182/blood.v108.11.3522.3522.

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Abstract MM is characterized by the presence of a monoclonal immunoglobulin (Ig) in the serum, produced by neoplastic plasma cells infiltrating the bone marrow (BM). Small amounts of free light chains (FLC) are secreted in normal individuals. In case of monoclonality, the FLC ratio increased. The detection and quantification of serum FLCs and of their ratio, was recently introduced as a useful method for the diagnosis and monitoring of light chain MM, amyloidosis, non-secretory MM and MGUS. However, the possible role of FLCR as a prognostic variable has not been investigated yet. We therefore
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26

Papaioannou, Paraskevi, Annita Ioanna Gkioka, Kallirroi Tsalimalma, et al. "Uninvolved Immunoglobulin Suppression Determined By "Hevylite" ASSAY. Strongly Predicts Evolution of Smoldering Myeloma (SMM) to Symptomatic Multiple Myeloma (MM)." Blood 132, Supplement 1 (2018): 5584. http://dx.doi.org/10.1182/blood-2018-99-118631.

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Abstract SMM may have an indolent course and remain stable for years; however, some patients evolve to MM requiring treatment within two years or less. To timely recognize these patients, three biomarkers (FLCR>100, ≥1 osteolysis and ≥60% plasma cell bone marrow infiltration) were recently established to discriminate asymptomatic MM patients at increased risk of rapid evolution and therefore, patients displaying the aforementioned biomarkers are considered symptomatic and receive immediate treatment. Despite the usage of the new IMWG definition criteria, there are still patients evolving ra
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27

Ståhlberg, Anders, Pierre Åman, Linda Strömbom, et al. "Comparison of Reverse Transcription Quantitative Real-Time PCR, Flow Cytometry, and Immunohistochemistry for Detection of Monoclonality in Lymphomas." ISRN Oncology 2014 (February 4, 2014): 1–6. http://dx.doi.org/10.1155/2014/796210.

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In healthy humans, 60–70% of the B lymphocytes produce kappa light chains, while the remaining cells produce lambda light chains. Malignant transformation and clonal expansion of B lymphocytes lead to an altered kappa : lambda expression ratio, which is an important diagnostic criteria of lymphomas. Here, we compared three methods for clonality determination of suspected B cell lymphomas. Tumor biopsies from 55 patients with B cell malignancies, 5 B-lymphoid tumor cell lines, and 20 biopsies from patients with lymphadenitis were analyzed by immunohistochemistry, flow cytometry, and reverse tra
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28

Hopson, Madeleine, Divaya Bhutani, Shawn M. Sarkaria, et al. "Impact of Light Chain Isotype on Clinical Features and Outcomes in Systemic AL Amyloidosis." Blood 138, Supplement 1 (2021): 4726. http://dx.doi.org/10.1182/blood-2021-149299.

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Abstract Purpose: In systemic AL amyloidosis, light chain (LC) isotype has been shown to predict outcome in patients undergoing upfront autologous transplantation. However, less than one-third of newly diagnosed AL patients are transplant-eligible. The objective of our study was to characterize the relationship between LC isotype, organ involvement, response, and survival in patients with newly diagnosed AL amyloidosis irrespective of transplant-eligibility. Methods: We performed a retrospective cohort study on 112 patients with AL amyloidosis who had treatment records at Columbia University I
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29

Stein, Regina, Jayesh Mehta, Eric Vickrey, William Resseguie, and Seema Singhal. "Correlation of Serum Free Light Chain Levels with Other Parameters in Myeloma." Blood 108, no. 11 (2006): 5019. http://dx.doi.org/10.1182/blood.v108.11.5019.5019.

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Abstract Estimation of serum free light chains (SFLC; SFKLC - kappa, SFLLC - lambda, SFKLR - kappa:lambda ratio; normal 0.26–1.65.) is useful in selected patients with non-secretory myeloma, and in light chain disease with anuric renal failure. Its utility in other clinical situations is unclear. 489 SFLC levels in 135 myeloma patients were analyzed to see if there was a significant correlation between them and other, more conventional immunologic parameters such as serum total light chain (STLC; STKLC - kappa, STLLC - lambda) levels and immunoglobulin (Ig) levels. The underlying premise was t
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30

Trieu, Young, Wei Xu, Peter Anglin, et al. "Evaluation of Serum Free Light Chains and Outcome in Multiple Myeloma Patients with an Intact Monoclonal Immunoglobulin Treated with Autologous Stem Cell Transplantation." Blood 112, no. 11 (2008): 3323. http://dx.doi.org/10.1182/blood.v112.11.3323.3323.

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Abstract Introduction: The serum free light chain (FLC) assay is a useful tool in diagnosing and monitoring multiple myeloma (MM) patients (pts) with non-secretory and light chain only disease. In addition, the detection of an abnormal serum FLC ratio is an adverse prognostic factor in pts with monoclonal gammopathy of undetermined significance. However, the relationship of the FLC assay to the outcome of patients with an intact monoclonal immunoglobulin following a single autologous stem cell transplantation (ASCT) has not been studied. Thus, the objective of this single centre, retrospective
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31

Vinayek, Namita, Goetz H. Kloecker, and Beth C. Riley. "Multiple Myeloma with Secretory and Non-Secretory Biclonal Gammopathy." Blood 118, no. 21 (2011): 5092. http://dx.doi.org/10.1182/blood.v118.21.5092.5092.

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Abstract Abstract 5092 Multiple myeloma (MM) accounts for 10 % of hematological malignancies. MM with biclonal gammopathy are rare and seen in 1 % of all MM cases. In 99% of the MM cases, paraproteins are secreted in the serum and/or urine, in the remaining 1% the paraproteins are synthesized but not secreted. Only 2 % of patients are younger than 40 years of age. We report a 36 year old African American female who presented with diffuse lytic lesions. Serum electrophoresis (SPEP) revealed IgG kappa M protein of 3.8 g/dl and a IgG Kappa M spike of 2.6 mg/dl. Free light chains (SFLC) revealed e
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32

Lischka, A., M. Graf, E. Hauser, and K. R. Herkner. "Kappa/Lambda Ratio as Parameter for Evaluation of Therapy-Resistant Epilepsy of Childhood." European Neurology 34, no. 1 (1994): 74–78. http://dx.doi.org/10.1159/000119515.

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33

Banerjee, Debasis. "Serum Free Light Chain Assay in Detection of Monoclonal Gammopathies: Relative Under-Detection of Lambda Dominant Kappa/Lambda Ratio." Journal of Applied Biochemistry & Laboratory Medicine 1, no. 1 (2020): 7–9. https://doi.org/10.5005/jablm-11031-01103.

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34

Alkhaibary, Ali, Ahoud Alharbi, and Sami Khairy. "Calvarial multiple myeloma: Raindrop skull." Surgical Neurology International 15 (February 9, 2024): 34. http://dx.doi.org/10.25259/sni_874_2023.

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Background: The “Raindrop skull” appearance represents the multiple punched-out and lytic lesions hitting a surface and creating a scattered splash pattern. Case Description: A 73-year-old female presented with multiple painless lumps over the forehead and head. The patient reported unintentional weight loss, fatigability, loss of appetite, fever, night sweats, and back pain for seven months (B symptoms). The examination revealed multiple, nonmobile, calvarial lesions with defined borders, measuring approximately 1 × 1 cm. Laboratory investigations of serum-free light chains showed a free kapp
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Jung, Jae Won, Myeong A. Cheong, Hyun Ju Kim, et al. "Increment of Serum Free Light Chain Kappa/Lambda Ratio in Patients with Renal Dysfunction." Laboratory Medicine Online 9, no. 1 (2019): 12. http://dx.doi.org/10.3343/lmo.2019.9.1.12.

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36

Larrea, Carlos Fernández de, Laura Magnano, Montserrat Elena, et al. "Prognostic Impact Of Serum Heavy/Light Chain Pairs In Patients With MGUS and Smoldering Myeloma: Long-Term Results From a Single Institution." Blood 122, no. 21 (2013): 3132. http://dx.doi.org/10.1182/blood.v122.21.3132.3132.

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Abstract Background Asymptomatic monoclonal gammopathies, such as monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM), are clinical conditions that usually precede symptomatic multiple myeloma (MM). However, risk stratification is crucial due to the heterogeneous progression rate among patients with these entities, particularly nowadays when chemoprevention trials are encouraged in high risk patients. In this sense, biomarkers and prognostic index based on tumoral load, M-protein behaviour (evolving vs. non-evolving) and/or immunological status have been deve
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37

Rajkumar, S. Vincent, Robert A. Kyle, Terry M. Therneau, et al. "Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance." Blood 106, no. 3 (2005): 812–17. http://dx.doi.org/10.1182/blood-2005-03-1038.

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AbstractWe hypothesized that the presence of monoclonal free kappa or lambda immunoglobulin light chains in monoclonal gammopathy of undetermined significance (MGUS), as detected by the serum free light chain (FLC) assay increases the risk of progression to malignancy. Of 1384 patients with MGUS from Southeastern Minnesota seen at the Mayo Clinic from 1960 to 1994, baseline serum samples obtained within 30 days of diagnosis were available in 1148. At a median follow-up of 15 years, malignant progression had occurred in 87 (7.6%) patients. An abnormal FLC ratio (kappa-lambda ratio < 0.26
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38

Voortman, Margarete M., Tatjana Stojakovic, Lukas Pirpamer, et al. "Prognostic value of free light chains lambda and kappa in early multiple sclerosis." Multiple Sclerosis Journal 23, no. 11 (2016): 1496–505. http://dx.doi.org/10.1177/1352458516681503.

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Background: Cerebrospinal fluid (CSF) immunoglobulin free light chains (FLC) have been suggested as quantitative alternative to oligoclonal bands (OCB) in the diagnosis of multiple sclerosis (MS). However, little is known on their role in predicting clinical and paraclinical disease progression, particularly in early stages. Objective: To assess the prognostic value of FLC in OCB-positive patients with clinically isolated syndrome (CIS) suggestive of MS and early MS. Methods: We determined FLC kappa (KFLC) and lambda (LFLC) in CSF and serum by nephelometry in 61 patients (CIS ( n = 48), relaps
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39

Sidana, Surbhi, Lisa Rybicki, Frederic J. Reu, and Thomas Daly. "High Serum Free Kappa Chains Are Frequently Missed By Serum Immunofixation." Blood 124, no. 21 (2014): 5708. http://dx.doi.org/10.1182/blood.v124.21.5708.5708.

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Abstract Background: Serum free light chains (sFLC) and immunofixation (IFE) analysis are used to detect monoclonal proteins. We noticed that some multiple myeloma (MM) patients (pts) had negative IFE results despite very high sFLC levels. This analysis was done to determine the frequency of this finding in a large cohort. Methods: Following IRB approval, samples with simultaneous sIFE and sFLCs ordered from 1/2013 to 9/2013 were identified by querying our lab electronic database. Freelite (R) Human Kappa & Lambda Free kit (The Binding Site, Birmingham, UK) was used for sFLC and SPIFE® Imm
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40

OBrien, Timothy, Kirsten Marie Boughan, Maria Navas, and Mohammad Qasim Ansari. "M-Protein Analysis Test: Effects of Combining Serum Protein Electrophoresis and Free Light Chain Assay Tests into One Order." Blood 142, Supplement 1 (2023): 6759. http://dx.doi.org/10.1182/blood-2023-190924.

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Background: Approximately 10-15% of clonal plasma cell disorders (PCDs, such as monoclonal gammopathy of undetermined significance or MGUS, smoldering myeloma or SMM, and multiple myeloma, MM) secrete light chains only, which are often missed on a serum protein electrophoresis (SPEP) and only detected on a serum free light chain (sFLC) or 24 hour urine (UPEP) assay. For this reason, the IMWG has recommended that screening tests for PCDs should include both an SPEP and sFLC. In 2020, clinicians at our institution were instructed to order an sFLC analysis in addition to an SPEP (with reflex immu
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41

Liyasova, Mariya, Michael Slade, Julie Fortier, et al. "Novel Assay for Quantification of Free Light Chain (FLC) Dimers in Serum of Patients with Plasma Cell Dyscrasias." Blood 142, Supplement 1 (2023): 2292. http://dx.doi.org/10.1182/blood-2023-186583.

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Free light chains (FLCs) are a well-established biomarker of plasma cell dyscrasias. FLCs exist as monomers, dimers and oligomers. Lambda FLC is particularly prone to form dimers and oligomers. Under certain pathological conditions, FLC dimerization changes towards the increased dimer formation. For instance, high levels of FLC dimers were found in AL amyloidosis and multiple myeloma (MM) even when the total FLC concentrations were near the normal levels. Thus, FLC dimer quantification can be used as a tool to diagnose and monitor AL amyloidosis and MM. Here we report a novel assay to detect a
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Villablanca, J. G., J. M. Anderson, M. Moseley, C. L. Law, R. L. Elstrom, and T. W. LeBien. "Differentiation of normal human pre-B cells in vitro." Journal of Experimental Medicine 172, no. 1 (1990): 325–34. http://dx.doi.org/10.1084/jem.172.1.325.

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The differentiation of surface Ig- pre-B cells into surface Ig+ B cells is a critical transition in mammalian B cell ontogeny. Elucidation of the growth factor requirements and differentiative potential of human pre-B cells has been hampered by the absence of a reproducible culture system that supports differentiation. Fluorescence-activated cell sorting and magnetic bead depletion were used to purify fetal bone marrow CD10+/surface mu- cells, which contain 60-70% cytoplasmic mu+ pre-B cells. CD10+/surface mu- cells cultured for 2 d were observed to differentiate into surface mu+ cells. Analys
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Ali, H., B. Mai, A. Wahed, A. Nguyen, J. Liu, and H. Zhu. "A Diagnostic Pitfall in the Evaluation of CD138-Positive Plasmacytoid Cells in a Fine Needle Aspiration Biopsy." American Journal of Clinical Pathology 156, Supplement_1 (2021): S84—S85. http://dx.doi.org/10.1093/ajcp/aqab191.179.

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Abstract Introduction/Objective The identification of plasmacytoid cells on rapid assessment leads to a wide range of differential diagnoses. Methods/Case Report We present a 51-year-old female with a parotid mass and cervical lymphadenopathy. The fine needle aspiration biopsy of the lymph node showed clusters of plasmacytoid cells. Flow cytometric studies showed cells positive for CD19, CD45, CD138 and kappa, but negative for CD38 and lambda. The kappa to lambda ratio was greater than 100. Histological sections showed plasmacytoid cells that were positive for AE1/AE3, S100, and SOX10, weakly
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Klotz, F. W., W. E. Gathings, and M. D. Cooper. "Development and distribution of B lineage cells in the domestic cat: analysis with monoclonal antibodies to cat mu-, gamma-, kappa-, and lambda-chains and heterologous anti-alpha antibodies." Journal of Immunology 134, no. 1 (1985): 95–100. http://dx.doi.org/10.4049/jimmunol.134.1.95.

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Abstract To trace the development and distribution of B lineage cells in the domestic cat (Felis catus), we have produced monoclonal antibodies against mu-, gamma-, kappa-, and lambda-chains of feline immunoglobulins (Ig). Goat antibodies against human mu-, alpha-, and lambda-chains, which are reactive with shared determinants on their feline counterparts, were used in conjunction with the panel of mouse monoclonal antibodies. Cytoplasmic mu+ pre-B cells and surface IgM+ B lymphocytes were observed in 42 day fetal liver in which pre-B cells were more abundant than IgM+ B cells. Pre-B cells als
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Reiter, Thomas, Daniela Knafl, Hermine Agis, Karl Mechtler, Ludwig Wagner, and Wolfgang Winnicki. "Structural analysis of urinary light chains and proteomic analysis of hyaline tubular casts in light chain associated kidney disorders." PeerJ 7 (October 2, 2019): e7819. http://dx.doi.org/10.7717/peerj.7819.

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Background Monoclonal overproduction of kappa and/or lambda light chains might result in renal light chain deposition disease. Light chain associated cast nephropathy and renal AL-amyloidosis represent two further pathologies going along with monoclonal gammopathy of renal significance and multiple myeloma. While cast nephropathy often manifests with acute kidney injury, AL-amyloidosis is rather accompanied with chronic kidney disease. Methods Urine samples were collected from 17 patients with multiple myeloma or monoclonal gammopathy. The urine sediment was stained for cast morphology by H/E
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Maurer, Matthew J., Ivana N. Micallef, Jerry A. Katzmann, Daniel Nikcevich, and Thomas E. Witzig. "Elevated Pre-Treatment Serum Immunoglobulin Free Light Chains (FLC) Are Associated with Poor Event-Free and Overall Survival in Diffuse Large B-Cell Lymphoma (DLBCL)." Blood 114, no. 22 (2009): 136. http://dx.doi.org/10.1182/blood.v114.22.136.136.

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Abstract Abstract 136 Background: The serum free light chain (FLC) assay quantitates free kappa and free lambda immunoglobulin light chains. This assay has prognostic value in MGUS, multiple myeloma (MM), solitary plasmacytoma, and AL amyloidoisis, and has been incorporated in response criteria for both MM and AL amyloidosis. A percentage of non-Hodgkin's lymphoma (NHL) patients also present with abnormal FLC concentrations and recent data suggest that AIDS patients with elevated serum FLC are at higher risk of developing NHL. Here we assess the impact of FLC in a cohort of patients with diffu
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47

Lee, Hye Ryun, Inho Kim, Sung-Soo Yoon, et al. "Usefulness of FICTION Method for the Evaluation of Response after Treatment in Multiple Myeloma." Blood 112, no. 11 (2008): 5112. http://dx.doi.org/10.1182/blood.v112.11.5112.5112.

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Abstract Introduction: According to the new uniform response criteria of International Myeloma Working Group (IMWG), stringent complete response (sCR) is defined as a condition of normal free light chain (FLC) ratio and absence of clonal cells in the bone marrow (BM) by immunohistochemistry or immunofluorescence, in addition to the CR condition. The kappa/lambda ratio is assessed to identify clonal cells in the BM and a minimum of 100 plasma cells is required for analysis of clonal cells. However, the evaluation of kappa/lambda ratio by immunohistochemistry or immunofluorescence may be inaccur
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48

Lee, Won Sok, and Gurmukh Singh. "Serum Free Light Chains in Neoplastic Monoclonal Gammopathies: Relative Under-Detection of Lambda Dominant Kappa/Lambda Ratio, and Underproduction of Free Lambda Light Chains, as Compared to Kappa Light Chains, in Patients With Neoplastic Monoclonal Gammopathies." Journal of Clinical Medicine Research 10, no. 7 (2018): 562–69. http://dx.doi.org/10.14740/jocmr3383w.

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49

Blagova, O. V., Yu A. Lutokhina, M. V. Kozhevnikova, E. A. Zheleznykh, A. Yu Fedorova, and E. A. Kogan. "Free Immunoglobulin Light Chains in Patients With Myocarditis: a New Biomarker of Inflammation and Heart Failure." Kardiologiia 64, no. 10 (2024): 12–23. http://dx.doi.org/10.18087/cardio.2024.10.n2700.

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Aim. To study the concentration of immunoglobulin free light chains (FLCs) in patients with myocarditis in comparison with non-inflammatory heart diseases, their relationship with inflammatory markers and the severity of chronic heart failure (CHF).Material and methods. This study included 77 patients (31 women, mean age 54.1±13.3 years): 41 patients with myocarditis verified by myocardial biopsy (n=18) or using a noninvasive diagnostic algorithm, 31 patients with noninflammatory CHF (comparison group), and 5 patients with monoclonal gammopathy identified during the study (4 of them were diagn
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50

Yeşilaltay, Alpay, and Saime Ramadan. "The correlation between serum free light chain levels and plasma cell ratio in bone marrow biopsy in multiple myeloma." Anatolian Current Medical Journal 6, no. 2 (2024): 150–54. http://dx.doi.org/10.38053/acmj.1429510.

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Aims: MM (Multiple myeloma) is the second most common hematological malignancy. In addition to the recent advances in treatment, new parameters are used in clinical practice in diagnosis and follow-up. sFLC (free chain kappa and lambda) shows the activation of the disease depending on the rate of MM malignant cell secretion in serum. However, the plasma cell (PC) ratio in bone marrow biopsy is still the gold standard in diagnosis. We examined the dynamic correlation between the PC ratio and the number of sFLC-related cells and the secretion rate. We aimed to examine whether a low PC ratio coul
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