Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland
We report three cases of light chain escape (LCE) at a single institution in Poland, including an interesting case of biclonal monoclonal gammopathy of undetermined significance (MGUS) that satisfied the criteria for progression to light chain multiple myeloma (LCMM) with a rapid rise in serum free...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2015/809840 |
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| author | Maria Kraj Barbara Kruk Kelly Endean Krzysztof Warzocha Katarzyna Budziszewska Monika Dąbrowska |
| author_facet | Maria Kraj Barbara Kruk Kelly Endean Krzysztof Warzocha Katarzyna Budziszewska Monika Dąbrowska |
| author_sort | Maria Kraj |
| collection | DOAJ |
| description | We report three cases of light chain escape (LCE) at a single institution in Poland, including an interesting case of biclonal monoclonal gammopathy of undetermined significance (MGUS) that satisfied the criteria for progression to light chain multiple myeloma (LCMM) with a rapid rise in serum free light chain (FLC) levels, following steroidal treatment for simultaneous temporal artery inflammation and polymyalgia rheumatica (PMR). In the three cases discussed, progression of the disease by light chain escape was associated with rapid and severe renal impairment, highlighting the necessity for prompt detection of such free light chain-only producing clones in order to prevent the possible development of irreversible end-organ damage. Interestingly, monitoring of these three patients by serum free light chain assay (sFLC) and retrospective heavy/light chain analysis (HLC) detected this clonal evolution prior to clinical relapse and suggests that these assays represent important additional tools for more accurate monitoring of multiple myeloma patients. |
| format | Article |
| id | doaj-art-61acb7ed975646d09d47a00eead7f100 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-61acb7ed975646d09d47a00eead7f1002025-02-03T05:57:32ZengWileyCase Reports in Hematology2090-65602090-65792015-01-01201510.1155/2015/809840809840Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in PolandMaria Kraj0Barbara Kruk1Kelly Endean2Krzysztof Warzocha3Katarzyna Budziszewska4Monika Dąbrowska5Institute of Hematology and Transfusion Medicine, Ulica Indiry Gandhi 14, 02-776 Warsaw, PolandInstitute of Hematology and Transfusion Medicine, Ulica Indiry Gandhi 14, 02-776 Warsaw, PolandThe Binding Site Group Ltd., 8 Calthorpe Road, Birmingham B151QT, UKInstitute of Hematology and Transfusion Medicine, Ulica Indiry Gandhi 14, 02-776 Warsaw, PolandInstitute of Hematology and Transfusion Medicine, Ulica Indiry Gandhi 14, 02-776 Warsaw, PolandInstitute of Hematology and Transfusion Medicine, Ulica Indiry Gandhi 14, 02-776 Warsaw, PolandWe report three cases of light chain escape (LCE) at a single institution in Poland, including an interesting case of biclonal monoclonal gammopathy of undetermined significance (MGUS) that satisfied the criteria for progression to light chain multiple myeloma (LCMM) with a rapid rise in serum free light chain (FLC) levels, following steroidal treatment for simultaneous temporal artery inflammation and polymyalgia rheumatica (PMR). In the three cases discussed, progression of the disease by light chain escape was associated with rapid and severe renal impairment, highlighting the necessity for prompt detection of such free light chain-only producing clones in order to prevent the possible development of irreversible end-organ damage. Interestingly, monitoring of these three patients by serum free light chain assay (sFLC) and retrospective heavy/light chain analysis (HLC) detected this clonal evolution prior to clinical relapse and suggests that these assays represent important additional tools for more accurate monitoring of multiple myeloma patients.http://dx.doi.org/10.1155/2015/809840 |
| spellingShingle | Maria Kraj Barbara Kruk Kelly Endean Krzysztof Warzocha Katarzyna Budziszewska Monika Dąbrowska Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland Case Reports in Hematology |
| title | Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland |
| title_full | Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland |
| title_fullStr | Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland |
| title_full_unstemmed | Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland |
| title_short | Light Chain Escape in 3 Cases: Evidence of Intraclonal Heterogeneity in Multiple Myeloma from a Single Institution in Poland |
| title_sort | light chain escape in 3 cases evidence of intraclonal heterogeneity in multiple myeloma from a single institution in poland |
| url | http://dx.doi.org/10.1155/2015/809840 |
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