Free light chain testing for the diagnosis, monitoring and prognostication of AL amyloidosis

Clin Chem Lab Med. 2016 Jun 1;54(6):921-7. doi: 10.1515/cclm-2015-0938.

Abstract

The disease causing agent in systemic AL amyloidosis is a monoclonal immunoglobulin free light chain, or fragments thereof, circulating in the blood. It is not surprising, therefore, that measurement of serum free light chains plays a central role in the management of this disorder. In this paper, we review the utility of the serum free light chain assay in the investigation, prognostication and monitoring of AL amyloidosis. Data on the two currently available commercial assays is compared and some practical applications of the assay's use are presented. While there are limitations, it is clear that the availability of the free light chain assay in the laboratory is a major advance and plays an essential role in the management of patients with AL amyloidosis.

Publication types

  • Review

MeSH terms

  • Amyloid / blood*
  • Amyloidosis / blood
  • Amyloidosis / diagnosis*
  • Amyloidosis / immunology
  • Humans
  • Immunoassay / methods
  • Immunoglobulin Light Chains / blood*
  • Natriuretic Peptide, Brain / blood
  • Paraproteins / analysis
  • Peptide Fragments / blood
  • Prognosis
  • Troponin I / blood

Substances

  • Amyloid
  • Immunoglobulin Light Chains
  • Paraproteins
  • Peptide Fragments
  • Troponin I
  • amyloid protein AL
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain