The impact of renal function on the clinical performance of FLC measurement in AL amyloidosis
Articolo
Data di Pubblicazione:
2016
Citazione:
The impact of renal function on the clinical performance of FLC measurement in AL amyloidosis / G. Palladini, P. Milani, A. Foli, M. Basset, F. Russo, T. Bosoni, L. Pirolini, V. Valentini, G. Ferraro, F. Lavatelli, A. Barassi, R. Albertini, G. Merlini. - In: CLINICAL CHEMISTRY AND LABORATORY MEDICINE. - ISSN 1434-6621. - 54:6(2016 Jun), pp. 939-945. [10.1515/cclm-2015-0985]
Abstract:
Background: The measurement of circulating free light chains (FLC) is of utmost importance in immunoglobulin light chain (AL) amyloidosis, being a fundamental part of the diagnostic workup, prognostic stratification and assessment of response to therapy. Renal failure is a common feature of AL amyloidosis and can considerably affect the concentration of FLC. Methods: We assessed the impact of renal failure on the clinical performance of the Freelite assay in 982 consecutive, newly diagnosed patients with AL amyloidosis, 822 with estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2, and 160 with eGFR <30 mL/min/1.73 m2. Results: The diagnostic sensitivity of the κ/λ FLC ratio was lower for λ amyloidogenic FLC in patients with renal failure (81% vs. 60%, p<0.001) and the FLC concentration had no independent prognostic significance in patients with severe renal dysfunction. However, FLC response to chemotherapy could still discriminate patients with better outcome. Conclusions: Renal failure is a relevant interference factor when using the Freelite assay for the identification of the amyloidogenic light chain and for prognostic assessment in patients with AL amyloidosis and renal failure.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
amyloidosis; free light chains; renal failure
Elenco autori:
G. Palladini, P. Milani, A. Foli, M. Basset, F. Russo, T. Bosoni, L. Pirolini, V. Valentini, G. Ferraro, F. Lavatelli, A. Barassi, R. Albertini, G. Merlini
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