M.-P. Beaumont-Epinette , C. Moreau , S. Besnard , F. Latute , N. Collet , M. Sebillot , B. Grosbois , C. Bendavid , L. Guenet , O. Decaux
{"title":"对于完整免疫球蛋白多发性骨髓瘤患者的诊断和随访，重链/轻链特异性免疫球蛋白比值不能提供比血清蛋白电泳和免疫固定更多的信息","authors":"M.-P. Beaumont-Epinette , C. Moreau , S. Besnard , F. Latute , N. Collet , M. Sebillot , B. Grosbois , C. Bendavid , L. Guenet , O. Decaux","doi":"10.1016/j.patbio.2015.06.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are used for diagnosis and follow-up of patients with intact immunoglobulin multiple myeloma. However, the numerous limitations of these methods led to the development of a nephelometric immunoassay (Hevylite™) for the specific measurement of serum IgGκ, IgGλ, IgAκ and IgAλ concentrations.</p></div><div><h3>Methods</h3><p>In this study, we evaluated the correlation between this assay and SPE and IFE in 114 sera of 15 patients (12 IgG and 3 IgA patients) and its impact on the clinical care of patients, especially for diagnosis, for the evaluation of residual disease and for early detection of relapse.</p></div><div><h3>Results</h3><p>At inclusion and during follow-up, we found a good correlation between monoclonal immunoglobulin concentrations and SPE (R<sup>2</sup> <!-->=<!--> <!-->0.902 for IgA and R<sup>2</sup> <!-->=<!--> <!-->0.915 for IgG) and nephelometric quantification (R<sup>2</sup> <!-->=<!--> <!-->0.948 for IgA and R<sup>2</sup> <!-->=<!--> <!-->0.920 for IgG) for the evaluation of monoclonal and polyclonal immunoglobulins. Our results illustrate that the Hevylite™ test is less sensitive than the IFE for detection of residual disease: 5 patients who obtained very good partial response or complete response had normalization of the Hevylite™ ratio while IFE was still positive. A relapse had been detectable with the Hevylite™ ratio 1 to 2 months earlier than with SPE and IFE in 3 patients out of 15, but no recommendations for treating patients with only slight biological relapse are available.</p></div><div><h3>Conclusion</h3><p>Our results demonstrate that heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients. We also studied the correlation between the concentration of total immunoglobulin measured by Hevylite™ (sum of Ig’κ + Ig’λ) and nephelometric measurement of total IgG or IgA. For this correlation analysis, all 114 sera were analyzed. The correlation coefficient was R<sup>2</sup> = 0.948 for IgA and R<sup>2</sup> = 0.920 for IgG.</p></div>","PeriodicalId":19743,"journal":{"name":"Pathologie-biologie","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.patbio.2015.06.001","citationCount":"6","resultStr":"{\"title\":\"Heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients\",\"authors\":\"M.-P. Beaumont-Epinette , C. Moreau , S. Besnard , F. Latute , N. Collet , M. Sebillot , B. Grosbois , C. Bendavid , L. Guenet , O. Decaux\",\"doi\":\"10.1016/j.patbio.2015.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are used for diagnosis and follow-up of patients with intact immunoglobulin multiple myeloma. However, the numerous limitations of these methods led to the development of a nephelometric immunoassay (Hevylite™) for the specific measurement of serum IgGκ, IgGλ, IgAκ and IgAλ concentrations.</p></div><div><h3>Methods</h3><p>In this study, we evaluated the correlation between this assay and SPE and IFE in 114 sera of 15 patients (12 IgG and 3 IgA patients) and its impact on the clinical care of patients, especially for diagnosis, for the evaluation of residual disease and for early detection of relapse.</p></div><div><h3>Results</h3><p>At inclusion and during follow-up, we found a good correlation between monoclonal immunoglobulin concentrations and SPE (R<sup>2</sup> <!-->=<!--> <!-->0.902 for IgA and R<sup>2</sup> <!-->=<!--> <!-->0.915 for IgG) and nephelometric quantification (R<sup>2</sup> <!-->=<!--> <!-->0.948 for IgA and R<sup>2</sup> <!-->=<!--> <!-->0.920 for IgG) for the evaluation of monoclonal and polyclonal immunoglobulins. Our results illustrate that the Hevylite™ test is less sensitive than the IFE for detection of residual disease: 5 patients who obtained very good partial response or complete response had normalization of the Hevylite™ ratio while IFE was still positive. A relapse had been detectable with the Hevylite™ ratio 1 to 2 months earlier than with SPE and IFE in 3 patients out of 15, but no recommendations for treating patients with only slight biological relapse are available.</p></div><div><h3>Conclusion</h3><p>Our results demonstrate that heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients. We also studied the correlation between the concentration of total immunoglobulin measured by Hevylite™ (sum of Ig’κ + Ig’λ) and nephelometric measurement of total IgG or IgA. For this correlation analysis, all 114 sera were analyzed. The correlation coefficient was R<sup>2</sup> = 0.948 for IgA and R<sup>2</sup> = 0.920 for IgG.</p></div>\",\"PeriodicalId\":19743,\"journal\":{\"name\":\"Pathologie-biologie\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.patbio.2015.06.001\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pathologie-biologie\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0369811415000565\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathologie-biologie","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0369811415000565","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients
Background
Serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) are used for diagnosis and follow-up of patients with intact immunoglobulin multiple myeloma. However, the numerous limitations of these methods led to the development of a nephelometric immunoassay (Hevylite™) for the specific measurement of serum IgGκ, IgGλ, IgAκ and IgAλ concentrations.
Methods
In this study, we evaluated the correlation between this assay and SPE and IFE in 114 sera of 15 patients (12 IgG and 3 IgA patients) and its impact on the clinical care of patients, especially for diagnosis, for the evaluation of residual disease and for early detection of relapse.
Results
At inclusion and during follow-up, we found a good correlation between monoclonal immunoglobulin concentrations and SPE (R2 = 0.902 for IgA and R2 = 0.915 for IgG) and nephelometric quantification (R2 = 0.948 for IgA and R2 = 0.920 for IgG) for the evaluation of monoclonal and polyclonal immunoglobulins. Our results illustrate that the Hevylite™ test is less sensitive than the IFE for detection of residual disease: 5 patients who obtained very good partial response or complete response had normalization of the Hevylite™ ratio while IFE was still positive. A relapse had been detectable with the Hevylite™ ratio 1 to 2 months earlier than with SPE and IFE in 3 patients out of 15, but no recommendations for treating patients with only slight biological relapse are available.
Conclusion
Our results demonstrate that heavy/light chain specific immunoglobulin ratios provides no additional information than serum proteins electrophoresis and immunofixation for the diagnosis and the follow-up of intact immunoglobulin multiple myeloma patients. We also studied the correlation between the concentration of total immunoglobulin measured by Hevylite™ (sum of Ig’κ + Ig’λ) and nephelometric measurement of total IgG or IgA. For this correlation analysis, all 114 sera were analyzed. The correlation coefficient was R2 = 0.948 for IgA and R2 = 0.920 for IgG.
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