Monoclonal free light chain detection and quantification: Performances and limits of available laboratory assays

Clin Biochem. 2021 Sep:95:28-33. doi: 10.1016/j.clinbiochem.2021.05.006. Epub 2021 May 12.

Abstract

The detection and quantification of immunoglobulin free light chains in serum and urine is recommended for the diagnosis and monitoring of monoclonal gammopathies according to the guidelines of the International Myeloma Working Group (IMWG). Several tests are currently available in the clinical laboratory to detect and quantify free light chains but although quality, efficiency, and effectiveness have been improved, the results are still variable and poorly harmonized and standardized. The present review article wants to analyze these aspects, with a keen eye on techniques, such as mass spectrometry, that could replace in the practical clinical laboratory the current methods including Bence-Jones protein assay and free light chain immunoassays.

Keywords: Electrophoresis; Free light chains; Laboratory methods; Mass spectrometry; Monoclonal gammopathy.

Publication types

  • Review

MeSH terms

  • Bence Jones Protein / analysis
  • Bence Jones Protein / urine
  • Biological Assay / methods*
  • Clinical Laboratory Services
  • Humans
  • Immunoassay / methods
  • Immunoglobulin Light Chains / analysis*
  • Immunoglobulin Light Chains / blood
  • Immunoglobulin Light Chains / chemistry
  • Mass Spectrometry / methods
  • Paraproteinemias / blood*
  • Paraproteinemias / urine*

Substances

  • Immunoglobulin Light Chains
  • Bence Jones Protein