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다발성골수종 환자의 진단 및 치료효과 추적을 위한 혈청 유리형 경쇄 정량검사의 의의

Serum Free Light Chains for Diagnosis and Follow-up of Multiple Myeloma

한경자|임지향|김용구|김명신|민창기|민우성|정선경|김명신1|임지향1|김용구1|한경자1|민창기2|민우성2
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2008.06|Annals of Laboratory Medicine|제28권 제3호|pp. 169-173

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Abstract

Background : Free light chain (FLC) is widely used to evaluate B-cell proliferative diseases. Herein, we estimated the clinical usefulness of serum FLC in multiple myeloma (MM). Methods : Fifty-one patients were enrolled. We performed FLC analysis, protein electrophoresis (PEP), and immunofixation electrophoresis (IFE). FLC was measured using Toshiba 200 FR Neo with FREELITETM, and kappa/lambda (κ/λ) ratio was calculated. We compared these parameters in 41 patients with increased FLC before and after bortezomib treatment. Complete response (CR) was defined as the disappearance of monoclonal (M) protein in serum and/or urine as measured by IFE. Partial response (PR) was defined as ≥50% reduction of serum M protein. Early objective response (EOR) included both CR and PR. Minimal response (MR) was defined as 25-49% reduction of M protein and stable disease (SD) as <25% reduction. Results : Forty-one (80.4%) of the 51 patients studied revealed increment of FLC and the five patients with no increment revealed an abnormal κ/λratio. Especially, all of the light chain myeloma and non-secretory myeloma showed increased FLC concentrations. Among the patients with EOR, 72.4% (21/29) showed a normal or subnormal FLC concentration after the first cycle of treatment. Otherwise, PEP and IFE normalized in 24.1% (7/29) and 24.1% (7/29), respectively. The ratio of decreased FLC after the first cycle of treatment was significantly different between EOR and other response groups (MR, SD) (90.6% vs 51.8%, P=0.011). Conclusions : FLC was considered as a good diagnostic method in complement with PEP and IFE in MM, especially in light chain myeloma or non-secretory myeloma. Moreover, FLC is a useful monitoring tool because it reflects therapy results more rapidly owing to a short serum half-life. (Korean J Lab Med 2008;28:169-73)

참고문헌 (15)

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