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Questions and discussion about smoldering myeloma (i.e., diagnosis, risk of progression, potential treatment, etc.)

Is FLC ratio reliable in biclonal gammopathy?

by jhorner on Fri Jul 25, 2014 1:21 pm

Hello,

I have IgG kappa and IgG lambda monoclonal gammopathy and they are both increasing in relatively parallel increments. Does this mean that the free light chain (FLC) ratio, which is most often considered for risk and qualification for clinical trials in smoldering myeloma, will never be a number that is reliable in my case?

There is a lot of emphasis placed on this value, so I'm wondering if it has any significance in a case of biclonal gammopathy of the same immunoglobulin?

Thanks!
J

jhorner
Name: Magpie
Who do you know with myeloma?: Myself
When were you/they diagnosed?: 2013
Age at diagnosis: 49

Re: Is FLC ratio reliable in biclonal gammopathy?

by Dr. Adam Cohen on Wed Jul 30, 2014 4:54 pm

Yes, it will be difficult to use the FLC ratio in your case, as both kappa and lambda will be elevated. If one starts to really take off compared with the other, then this would be informative, but otherwise I don't think it will be very helpful for risk stratification purposes.

Dr. Adam Cohen
Name: Adam D. Cohen, M.D.
Beacon Medical Advisor

Re: Is FLC ratio reliable in biclonal gammopathy?

by DanaH on Mon Aug 18, 2014 11:20 am

I am wondering if the newly FDA approved HevyLite assay (the Binding Site) would be a more useful tool in a biclonal gammopathy?

Any thoughts on its utility in this situation as related to risk stratification?

Many thanks,
Dana H

DanaH
Who do you know with myeloma?: Myself, SMM as of 1/2012
When were you/they diagnosed?: 1/2012
Age at diagnosis: 54

Re: Is FLC ratio reliable in biclonal gammopathy?

by Anonymouss on Mon Aug 18, 2014 2:51 pm

What is the Hevylite test ? Is it a blood test like the free light chain test?

Thanks.

Anonymouss

Re: Is FLC ratio reliable in biclonal gammopathy?

by Beacon Staff on Mon Aug 18, 2014 2:58 pm

Hi Anonymouss,

Yes, the HevyLite Assay is a new test from the same company that developed the Freelite assay used for determining free light chain levels.

You can read more about the HevyLit assay at these links:

http://www.thebindingsite.com/news?story=402

From the above link: "The Hevylite assays are a family of novel tests that can distinguish and quantify specific intact heavy/light chain combinations from myeloma clones, including cases where traditional electrophoretic techniques are insufficiently sensitive. The sensitivity of Hevylite makes it a potentially valuable tool for serial monitoring treatment in patients with IgG and IgA myeloma as Hevylite may help identify early relapse and residual disease."

http://www.thebindingsite.com/hevylite

http://www.wikilite.com/wiki/index.php/Analysis_of_Ig_heavy_chain/light_chain_pairs_(Hevylite%E2%84%A2)

Beacon Staff


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