Serum Free Light Chain Testing in AL Amyloidosis: Diagnosis, Monitoring, and Prognosis
This review evaluates the central role of the serum free light chain assay in managing systemic AL amyloidosis, comparing two commercially available assays. Free light chain measurement has become indispensable for diagnosis, treatment response monitoring, and prognostication, though the authors note important analytical limitations that laboratories must understand for accurate clinical interpretation.
The original study
Free light chain testing for the diagnosis, monitoring and prognostication of AL amyloidosis.
- Authors
- Mollee P, Merlini G
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 26812792
Original abstract
The disease causing agent in systemic AL amyloidosis is a monoclonal immunoglobulin free light chain, or fragments thereof, circulating in the blood. It is not surprising, therefore, that measurement of serum free light chains plays a central role in the management of this disorder. In this paper, we review the utility of the serum free light chain assay in the investigation, prognostication and monitoring of AL amyloidosis. Data on the two currently available commercial assays is compared and some practical applications of the assay's use are presented. While there are limitations, it is clear that the availability of the free light chain assay in the laboratory is a major advance and plays an essential role in the management of patients with AL amyloidosis.