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Editor-in-chief
Maria Stella Graziani
Deputy Director
Martina Zaninotto
Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali
EIC Assistant
Francesco Busardò
International Advisory Board
Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada
Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano
Responsible Editor
Giuseppe Agosta
Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091
BC: Articoli scritti da G. Trapè
La misura delle catene leggere libere e i recenti criteri diagnostici del mieloma multiplo
The free light chain measurement and the recent Multiple Myeloma diagnostic criteria
<p>In 2014, the International Myeloma Working Group updated the criteria for the diagnosis of Multiple Myeloma (MM), adding to the classic CRAB features (hypercalcaemia, renal failure, anemia, and bone lesions) a recently validated biomarker and recommended the implementation of this criterium in the routine practice. The biomarker is the ratio of involved to non-involved free light chain ≥100, provided that the involved light chain is ≥100 mg/L. We report the case of a man aged 68, referring to our Hematology Unit in March 2016 who was diagnosed with a monoclonal gammopathy of undetermined significance since 2009. Serum protein electrophoresis and immunofixation were performed, along with serum free light chain (sFLC) quantification. During the follow-up, despite the small peak entity, the sFLC kappa concentration was very high (3684 mg/L; reference interval 3.3-19.40) with an abnormal sFLC ratio (304; reference interval 0.26-1.65). At that stage, the patient did not show any signs of CRAB features, however a drug treatment was started. For months later, a magnetic resonance revealed a numer of lytic lesions. This case underlines the crucial role of sFLC in the management of patients with plasmacell dyscrasias and shows how sFLC ratio can induce early treatment before the development of major organ damage.</p>
Biochimica Clinica ; 42(3) e33-e36 Casi clinici - Case report
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