title: Serum-free light-chain analysis in diagnosis and management of multiple myeloma and related conditions.
abstract: The introduction of the serum-free light-chain (S-FLC) assay has been a breakthrough in the diagnosis and management of plasma cell dyscrasias, particularly monoclonal light-chain diseases. The first method, proposed in 2001, quantifies serum-free light-chains using polyclonal antibodies. More recently, assays based on monoclonal antibodies have entered into clinical practice. S-FLC measurement plays a central role in the screening for multiple myeloma and related conditions, in association with electrophoretic techniques. Analysis of S-FLC is essential in assessing the risk of progression of precursor diseases to overt plasma cell dyscrasias. It is also useful for risk stratification in solitary plasmacytoma and AL amyloidosis. The S-FLC measurement is part of the new diagnostic criteria for multiple myeloma, and provides a marker to follow changes in clonal substructure over time. Finally, the evaluation of S-FLC is fundamental for assessing the response to treatment in monoclonal light chain diseases.
authors.affiliation: a Amyloidosis Research and Treatment Center, Foundation IRCCS Policlinico San Matteo and Department of Molecular Medicine , University of Pavia , Pavia , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Milani
authors.affiliation: a Amyloidosis Research and Treatment Center, Foundation IRCCS Policlinico San Matteo and Department of Molecular Medicine , University of Pavia , Pavia , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palladini
authors.affiliation: a Amyloidosis Research and Treatment Center, Foundation IRCCS Policlinico San Matteo and Department of Molecular Medicine , University of Pavia , Pavia , Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
mesh_terms: D000686:Amyloidosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000097:blood* / Q000652:urine; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood / Q000652:urine; D019468:Disease Management; D018450:Disease Progression; D004586:Electrophoresis / Q000592:standards; D006801:Humans; D007118:Immunoassay / Q000592:standards; D007147:Immunoglobulin Light Chains / Q000097:blood* / Q000652:urine; D000075363:Immunoglobulin Light-chain Amyloidosis; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010954:Plasmacytoma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D011379:Prognosis; D018570:Risk Assessment
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D015415:Biomarkers; D007147:Immunoglobulin Light Chains
keywords: AL amyloidosis; electrophoresis; immunofixation; prognosis; response to therapy; screening