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Review

Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma

by
Cecilia Napodano
1,†,
Laura Ioannilli
2,†,
Valerio Basile
3,
Francesca Gulli
4,
Valeria Carnazzo
5,
Stefano Pignalosa
5,
Luigi Di Biase
5,
Erica Cavaleri
5,
Cosimo Racco
5,
Francesco Equitani
6,
Mariapaola Marino
7,8,*,‡ and
Umberto Basile
5,*,‡
1
Department of Laboratory Medicine and Pathology, S. Agostino Estense Hospital, 41126 Modena, Italy
2
Scientific Department, The Binding Site Italy, Part of Thermo Fisher Scientific, 24050 Bergamo, Italy
3
Clinical Pathology Unit and Cancer Biobank, Department of Research and Advanced Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
4
Clinical Biochemistry Laboratory, IRCCS “Bambino Gesù” Children’s Hospital, 00165 Rome, Italy
5
Department of Clinical Pathology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy
6
Department of Transfusion Medicine and Immuno-Hematology, Santa Maria Goretti Hospital, AUSL Latina, 04100 Latina, Italy
7
Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
8
Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
‡
These authors joined supervision.
J. Pers. Med. 2023, 13(5), 743; https://doi.org/10.3390/jpm13050743
Submission received: 30 March 2023 / Revised: 19 April 2023 / Accepted: 25 April 2023 / Published: 27 April 2023
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Abstract

The antibody-related immune response is mediated by immunoglobulins (Igs), soluble circulating glycoproteins produced by activated B cells that, upon the recognition of specific epitopes on pathogen surfaces, activate, proliferate, and differentiate into antibody-secreting plasma cells. Although the antibodies are effectors of the humoral immune adaptive response, their overproduction in response to a dysregulated proliferation of clonal plasma cell production in tumoral conditions (i.e., multiple myeloma), enriches the serum and urinary matrices, assuming the crucial role of biomarkers. Multiple myeloma (MM) is a plasma cell dyscrasia characterized by the expansion and accumulation of clonally activated plasma cells in bone marrow, determining the release of high amounts of monoclonal component (MC) that can be detected as intact immunoglobulin (Ig), immunoglobulin fragments, or free light chains (FLCs). The importance of detecting biomarkers for the diagnosis, monitoring, and prognosis of diseases is highlighted by the international guidelines that recommend specific assays for the analysis of intact Igs and FLC. Moreover, a developed assay called Hevylite® allows for the quantification of immunoglobulins that are both involved (iHLC) and not involved (uHLC) in the tumor process; this is a fundamental aspect of following up the patient’s workup and evaluating the progression of disease, together with the treatments response. We here summarize the major points of the complex scenario involving monoclonal gammopathies and MM clinical management in view of advantages derived for the use of Hevylite®.
Keywords: multiple myeloma; free light chain; monoclonal component; heavy/light chain multiple myeloma; free light chain; monoclonal component; heavy/light chain

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MDPI and ACS Style

Napodano, C.; Ioannilli, L.; Basile, V.; Gulli, F.; Carnazzo, V.; Pignalosa, S.; Di Biase, L.; Cavaleri, E.; Racco, C.; Equitani, F.; et al. Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma. J. Pers. Med. 2023, 13, 743. https://doi.org/10.3390/jpm13050743

AMA Style

Napodano C, Ioannilli L, Basile V, Gulli F, Carnazzo V, Pignalosa S, Di Biase L, Cavaleri E, Racco C, Equitani F, et al. Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma. Journal of Personalized Medicine. 2023; 13(5):743. https://doi.org/10.3390/jpm13050743

Chicago/Turabian Style

Napodano, Cecilia, Laura Ioannilli, Valerio Basile, Francesca Gulli, Valeria Carnazzo, Stefano Pignalosa, Luigi Di Biase, Erica Cavaleri, Cosimo Racco, Francesco Equitani, and et al. 2023. "Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma" Journal of Personalized Medicine 13, no. 5: 743. https://doi.org/10.3390/jpm13050743

APA Style

Napodano, C., Ioannilli, L., Basile, V., Gulli, F., Carnazzo, V., Pignalosa, S., Di Biase, L., Cavaleri, E., Racco, C., Equitani, F., Marino, M., & Basile, U. (2023). Laboratory and Clinical Settings of Heavy/Light Chain (HLC) Assays in the Management of Monoclonal Gammopathies and Multiple Myeloma. Journal of Personalized Medicine, 13(5), 743. https://doi.org/10.3390/jpm13050743

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