The IMWG guidelines recommend Freelite for the diagnosis of monoclonal gammopathies.
A combination of Freelite and SPE/CZE is a clinically sensitive strategy for the diagnosis
of monoclonal gammopathies and allows urine testing to be used more selectively.
Protocols
% of Paraproteins detected
Myeloma
AL amyloidosis
LCMM
NSMM
SPE alone
88
66
40 - 57
0
Serum IFE
94
74
n.d.
0
SPE, serum IFE, urine IFE
100
94
n.d.
0
SPE/CZE and Freelite
100
96
100
68
SPE/CZE, Freelite and serum IFE
100
97
100
68
SPE - Serum Protein Electrophoresis
IFE - Immunofixation Electrophoresis
CZE - Capillary Zone Electrophoresis
LCMM - Light Chain Multiple Myeloma
NSMM - Non Secretory Multiple Myeloma
The high diagnostic sensitivity of the serum k/λ FLC ratio identifies additional B cell malignancies that would otherwise be negative by conventional electrophoretic techniques.