The expanding clinical utility of blood neurofilament light chain (bNfL): a multi-disciplinary diagnostic tool

Background

The protein neurofilament light chain in blood (bNfL) has become a valuable biomarker in the diagnosis, monitoring, and prognosis of neurological diseases. However, its potential use beyond neurology in routine clinical practice remains unexplored. This study aimed to examine the clinical utility of bNfL by investigating its expanding use (i) assessing its integration into in- and outpatient routine practice, (ii) both within and outside of academic hospitals, and (iii) across different medical disciplines and various departments.

Methods

This study examined data from two large clinical chemistry laboratories that provide bNfL measurements for the clinical routine: Labor Berlin, Germany, and the Clinical Neurochemistry Laboratory at Sahlgrenska University Hospital, Sweden. Together, this large-scale retrospective study acquired data on bNfL measurements from n = 22,122 individuals during the years 2021 to 2023.

Results

Our findings revealed that (i) outpatient clinics and (ii) non-academic healthcare settings are gradually integrating bNfL into their routine practice and (iii) its use has expanded across an increasing number of medical disciplines over time, indicating its growing importance as a diagnostic tool, beyond neurology. Notably, departments such as cardiology, hematology/oncology and intensive care units increasingly incorporated bNfL into their clinical repertoire.

Discussion

This study underscores the developing impact of easily accessible bNfL on clinical routine, not only enhancing neurologists' diagnostic tools but also offering valuable insights into diverse medical fields, in- and outside the academic environment.