EBCT 3: Serum free light chains

Question 1

What is a plasma cell?

Answer 1

An activated b lymphocyte. if made in 2ndary lymphoid organ, short lived and IgM secreting, if made in BM long lived and IgG/A secreting

Question 2

Polyclonal plasma cells?

Answer 2

All different, produce polyclonal antibodies

Question 3

HOW DO WE KNOW IF THERE IS A PLASMA CELL TUMOR?

Answer 3

identical copies of one plasma cell are present (monoclonal proliferation) and they produce identical (monoclonal) immunoglobulin proteins

Question 4

What is serum protein electrophoresis? and what does it screen for?

Answer 4

screens for b cell malignancy and immunodeficiency. separates proteins by size and charge on agarose gel then quantifies peaks by density. doesnt measure light chains, out of range.

Question 5

measurement of serum free light chains?

Answer 5

FREELITE assay, specific for free light chains.

Question 6

Nephelometry?

Answer 6

free light chain measuring

Question 7

Probs with sFLC norm range?

Answer 7

renal impairement not caused by monoclonal gammopathy have increased kappa and lambra concs but a normal ratio, so in the norm zone

Question 8

What is IFE and what does it do?

Answer 8

Immunofixation electrophoresis and it IDs paraprotein type and is non quantative. gives prognostic info.

Question 9

What is FREELITE good for at first point (after initial tratment)

Answer 9

as an indicator of response to treatment rather than monitoring intact Ig levels

Question 10

What is treatment failure indicated by?

Answer 10

sFLC

Question 11

What is a disadvantage to detecing monoclonal light chains using urine protein electrophoresis?

Answer 11

affected by renal function, insensitive, 24 hr urine collection hard/time consuming

Question 12

What are advantages to serum free light chain assay?

Answer 12

sensitive, k/g ratio little affected by renal function, easy quick and wuantitatieve