A peer-reviewed publication documenting the rapid diagnosis of multiple myeloma in Acute Kidney Injury patients (AKI) using Seralite® - FLC Serum (Seralite®), a rapid free light chain test, has been published in BMC Nephrology.
Renal impairment is common in multiple myeloma and has a negative impact on survival. In patients presenting with an AKI where the underlying pathology is unknown, multiple myeloma should be investigated as a potential cause.
The International Myeloma Working Group recommends screening for myeloma using serum immunoelectrophoresis (IFE), serum protein electrophoresis (SPE), and serum free light chain (sFLC) assays. The timescales for routine IFE, SPE and sFLC may not be compatible with the emergency setting of a patient presenting with AKI.
The aim of this study was to assess the utility of Seralite® as a screening tool to distinguish between myeloma and non-myeloma related AKI. The publication highlights that Seralite® could reduce delays in obtaining sFLC results and accelerate diagnosis in patients with unexplained AKI.
The key conclusions from this publication are:
“The Seralite® κ:λ FLC ratio accurately diagnosed all MM patients in the presence of Acute Kidney Injury: a range of 0.14–2.02 returned 100% sensitivity and specificity for identifying all non-myeloma related AKI patients.”
“Serum FLC quantitation via Seralite® could be used as an effective screening tool for myeloma in patients presenting with AKI stage 3. The FLC ratio sensitively and specifically distinguishes between patients with AKI and myeloma or AKI attributable to other causes.”
“Importantly, the portable device offered the same level of diagnostic performance previously reported for conventional laboratory-based testing. The published renal reference for the κ:λ ratio using Freelite® (0.37–3.1) is associated with 100% sensitivity and 99% specificity for detecting nephrotoxic monoclonal FLCs in 41 myeloma patients with AKI.”
“FLC nephelometric and turbidimetric assays are not available in all hospitals, often necessitating sample dispatch to specialised laboratories. When using automated analysers, samples are routinely run in batches and thus testing may not be carried out every day. This can lead to sample turn-around times of days to weeks and cause delays that may jeopardise the chance of renal recovery. Seralite® accelerates the processing of urgent samples and it could be used to generate results in 10 minutes by any hospital that operates a 24hr laboratory service. Early diagnosis and treatment intervention in myeloma is central to disease-free survival but is particularly important in the context of myeloma and AKI.”
This publication highlights the importance of early diagnosis of multiple myeloma in patients presenting with Acute Kidney Injury. The authors conclude that as a rapid test, Seralite® is easily applicable to testing urgent samples in routine hospital laboratories and therefore could be used to speed up the diagnosis of myeloma in AKI patients, in whom prompt intervention is vital to provide the best chance of renal recovery and improve patient prognosis.
Full access to this article can be obtained via the link: https://bmcnephrol.biomedcentral.com/track/pdf/10.1186/s12882-017-0661-z