Ascendant Medical Laboratory

Ascendant Medical Laboratory in Knoxville offers the serum Free Light Chain assay to measure levels of free Kappa and Lambda immunoglobulin light chains for the evaluation and management of myeloma and related plasma cell disorders (PCD).

Guidelines for analysis of serum free light chains in multiple myeloma and related disorders, are a result of collaboration by the International Myeloma Working Group.

The key recommendations from the International Myeloma Working Group’s guidelines are:

SCREENING: In combination with serum protein electrophoresis (SPE) and serum immunofixation (IFE), this panel yields high sensitivity, and NEGATES the need for 24-hour urine studies when screening for monoclonal plasma cell proliferative disorders. However, once a diagnosis of a plasma cell disorder is made, a 24-hour urine for SPE and IFE is essential for all patients. AL amyloidosis is the exception, as it requires all the serum tests as well as the 24-hour urine IFE for initial screening.

PROGNOSIS: The BASELINE serum Free Light Chain measurement is of major prognostic value in virtually every plasma cell disorder, including monoclonal gammopathy of unknown significance, smoldering or active myeloma, AL amyloidosis and solitary plasmacytoma.

MONITORING: Serial serum Free Light Chain analysis in patients with oligosecretory plasma cell disorders should be routinely performed. There are no data, however, to support using the serum Free Light Chain assay in place of 24-hour urine SPE for monitoring myeloma patients with intact immunoglobulin monoclonal gammopathy.

RESPONSE ASSESSMENT: Serial Free Light Chain levels should be routinely tested in AL amyloidosis and myeloma patients with oligosecretory disease. Patients with a Complete Response should be measured to determine attainment of stringent Complete Response.

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