The role of the assessment of heavy/light chain pairs of immunoglobulin in monoclonal gammopathies

Česká verzia

Authors: Vlastimil Ščudla ^1,2; Tomáš Pika ²; Jiří Minařík ²
Authors place of work: III. interní klinika – nefrologie, revmatologie, endokrinologie LF UP a FN Olomouc, přednosta prof. MUDr. Josef Zadražil, CSc. ¹; Hemato-onkologická klinika LF UP a FN Olomouc, přednosta prof. MUDr. Tomáš Papajík, CSc. ²
Published in the journal: Vnitř Lék 2015; 61(1): 60-71
Category: Reviews

Summary

The aim of the paper is to inform about the contribution of novel, highly sensitive analytic technique for the assessment of serum immunoglobulins (Hevylite™), enabling separate quantitative assessment of heavy/light chain pairs of immunoglobulin (HLC), i. e. the monoclonal („involved“) and polyclonal („noninvolved“) isotype including their ratio (HLC-r) in monoclonal gammopathies. We particularly target the characteristics of this technique, the comparison of its clinical contribution with standard methods used in the diagnostics, course and the detection of relapse and progression of the disease, as well as the stratification, assessment of therapeutic outcome and prognosis in monoclonal gammopathy of undetermined significance, multiple myeloma, Waldenström´s macroglobulinemia, systemic AL-amyloidosis and some non-Hodgkin lymphomas. Present results show that in comparison with existing routinely used techniques the Hevylite™ method enriches clinical practice with the assessment of serum levels of „uninvolved“ Ig. It enables the evaluation of the depth of „immunoparesis“, and the determination of HLC-r index that is needful for the stratification of MM into „risk cohorts“. It also contributes to prognostic assessment and improvement of the evaluation of the depth of therapeutic response. In MGUS individuals the HLC-r index provides information about the risk of malignant transformation. We await the results of ongoing validation studies that are expected to provide specific indications for Hevylite™ technique for MG in routine practice.

Key words:
heavy/light chain pair of immunoglobulin – Hevylite™ – monoclonal immunoglobulin – monoclonal gammopathy of undetermined significance – multiple myeloma – non-Hodgkin lymphomas – systemic AL-amyloidosis – Waldenström´s macroglobulinemia

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