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Comparison of Free Light Chain Assays Freelite and N Latex in Diagnosis, Monitoring, and Predicting Survival in Light Chain Amyloidosis

Mahmood, S; Wassef, NL; Salter, SJ; Sachchithanantham, S; Lane, T; Foard, D; Whelan, CJ; ... Wechalekar, AD; + view all (2016) Comparison of Free Light Chain Assays Freelite and N Latex in Diagnosis, Monitoring, and Predicting Survival in Light Chain Amyloidosis. American Journal of Clinical Pathology , 146 (1) pp. 78-85. 10.1093/ajcp/aqw079. Green open access

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Abstract

OBJECTIVE: Measurement of serum free light chains (FLCs) is critical in diagnosis, prognosis, and monitoring treatment responses in light chain (AL) amyloidosis. We compare the Freelite assay (polyclonal antibodies to hidden light chain epitopes), which is the current gold standard, with a new assay: a mixture of monoclonal antibodies to light chain epitopes (N Latex). METHODS: We collected 240 serum samples from 94 consecutive patients with newly diagnosed AL amyloidosis (at least three serial serum samples during the first 6 months) analyzed at the National Amyloidosis Centre, London, from January 2011 to April 2012. Concordance in detecting abnormal light chain components and hematologic response was assessed at 2, 4, and 6 months. RESULTS: The κ and λ clonal light chain involvement was 21% and 79%, respectively, with an abnormal κ/λ ratio or detectable protein in 78.7%. Median κ, λ, and difference in involved and uninvolved FLCs by Freelite and N Latex assays were 17.3 vs 16 mg/L (R2  = 0.91), 48.8 vs 52.6 mg/L (R2 = 0.52), and 43.2 vs 39.1 mg/L, respectively. Discordant κ/λ ratios at presentation were as follows: 10 of 90 abnormal by Freelite/normal by N Latex and 11 of 90 abnormal by N Latex/normal by Freelite. CONCLUSIONS: Both FLC assays show good correlation in detecting the abnormal light chain subtype with discordance in absolute values and thus are not interchangeable.

Type: Article
Title: Comparison of Free Light Chain Assays Freelite and N Latex in Diagnosis, Monitoring, and Predicting Survival in Light Chain Amyloidosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ajcp/aqw079
Publisher version: http://dx.doi.org/10.1093/ajcp/aqw079
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Light chain assays, Freelite, N Latex, Prognostic utility, Light chain amyloidosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/1502770
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