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Interlaboratory study of free monoclonal immunoglobulin light chain quantification

  • Jaroslava Vávrová , Vladimír Maisnar , Miloš Tichý EMAIL logo , Bedřich Friedecký , Zdeňka Čermáková , Milan Dastych , Jana Gottwaldová , Petr Kučera , Jarmila Krotká , Jaroslav Racek , Jana Ženková , Petr Schneiderka , Pavel Lochman , Tomáš Zima , Hana Benáková , Tomáš Büchler , Jana Spáčilová , Roman Hájek and Vladimír Palička
Published/Copyright: October 30, 2010

Abstract

Background: Quantification of monoclonal immunoglobulin free light chains (FLCs) in serum is used increasingly in clinical practice for the diagnosis, prognostic assessment, and treatment monitoring of monoclonal gammopathies. It is used as an adjunct to standard serum protein electrophoresis and immunofixation. However, methods for FLC quantification need further standardization and validation.

Methods: The Czech Myeloma Group and the Czech Society of Clinical Biochemistry have initiated an interlaboratory study where six laboratories collaborating with the primary myeloma treatment centres measured FLC concentrations in 12 serum samples from patients with monoclonal gammopathies.

Results: Repeatability of the measurements in five laboratories was calculated based on differences between the results of duplicate measurements. We found that repeatability depended more on the laboratory than on the device used for measurement.

Conclusions: The study revealed several weak points in the methodology, including the need for a uniform sample dilution procedure. Interlaboratory reproducibility was comparable with values achieved in the NEQAS programme. Because the κ/λ ratio cannot be measured with high precision, κ and λ FLC concentrations should be used where possible. Due to its impact on the clinical management of patients with gammopathy, FLC quantification needs to become a part of the regular quality control cycle in myeloma centres.


Corresponding author: Prof. Miloš Tichý, Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, 500 05 Hradec Kralove, Czech Republic Phone: +420 495 832 274, Fax: +420 495 832 003

Received: 2010-3-10
Accepted: 2010-7-2
Published Online: 2010-10-30
Published in Print: 2011-01-01

©2011 by Walter de Gruyter Berlin New York

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