Quantification of β region IgA paraproteins - should we include immunochemical "heavy/light chain" measurements? Counterpoint

被引:6
作者
Paolini, Lucia [1 ]
机构
[1] Univ Brescia, Fac Med, Dept Mol & Translat Med, Viale Europa 11, I-25123 Brescia, Italy
关键词
heavy/light chain; immunoglobulin; monoclonal component quantification; plasma cell dyscrasias; RATIOS; ELECTROPHORESIS; IMMUNOFIXATION; PROGRESSION; DIAGNOSIS; ASSAYS; SERUM; HLC;
D O I
10.1515/cclm-2015-0692
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Serum protein electrophoresis (SPE), serum immunofixation (s-IFE), free light chain measurement (FLC) and nephelometric measurements of total immunoglobulin in serum (IgTot) are some of the laboratory tests required for the management of plasma cell proliferative disorders. The monoclonal protein is usually visible on SPE as a spike (M-spike) in the. region and the derived densitogram is used to quantify it relative to serum total protein concentration. IgA M-protein, however, often migrates in the beta region on SPE and its quantification can be masked by other serum proteins that migrate in this region. The immunoassay Hevylite(TM) (heavy/light chain, HLC) seems to solve this problem: it quantifies the involved/uninvolved isotype, - calculating the ratio IgA kappa/IgA lambda, considered indicative of clonal proliferation. However, this test seems redundant in the case of artifacts on SPE such as obvious hemolysis or lipemia, or if the IgA M-spike is clearly visible in the beta region. In conclusion whereas the IgA HLC assay does not represent an alternative to SPE and s-IFE in the diagnostic patient workup, it may prove to be an alternative to SPE, s-IFE and total IgA quantification in risk stratification and evaluation of response to therapy in patients affected by MM and other monoclonal plasma proliferative disorders.
引用
收藏
页码:1059 / 1064
页数:6
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