Lab Med Online.  2015 Jul;5(3):127-132. 10.3343/lmo.2015.5.3.127.

Evaluation of the Effectiveness of the Heavy-Light Chain Quantitative Test

Affiliations
  • 1Department of New Health Technology Assessment Research, National Evidence-based, Healthcare Collaborating Agency, Seoul, Korea.
  • 2Department Public Health, The Graduate School of Yonsei University, Seoul, Korea.
  • 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kimjw@skku.edu

Abstract

BACKGROUND
The heavy-light chain (HLC) quantitative test can identify and quantify the heavy and light chains of each immunoglobulin class. The purpose
of this study was to evaluate the effectiveness of the HLC quantitative test.
METHODS
To evaluate the effectiveness of the HLC quantitative test, a systemic review of the literature, using Ovid-MEDLINE, EMBASE, Cochrane library, and eight domestic databases including KoreaMed, was performed until October 10, 2013. We included five cohort studies and one diagnostic evaluation study in the final evaluation. Two reviewers independently assessed the quality of the included studies and extracted data from the studies. The quality of the studies was assessed according to the Scottish Intercollegiate Guidelines Network (SIGN) tool.
RESULTS
A correlation between the HLC quantitative test and previous assays was evaluated in one study, which enrolled patients with increased monoclonal IgA. The correlation coefficient was reported as 0.94 in this study. The clinical significance of the quantitative HLC test to predict a prognosis was also reported in five cohort studies. The survival rate in patients with higher HLC ratio was significantly lower and the increased IgA kappa/lambda ratio or IgM kappa/lambda ratio was significantly correlated with higher survival rate in patients with monoclonal gammaglobulinemia.
CONCLUSIONS
The HLC quantitative test is an effective test that can quantitatively measure the identified immunoglobulin type and predict the prognosis of patients with monoclonal gammopathy.

Keyword

Heavy/light chain assay; Monoclonal gammopathy; Monoclonal immunoglobulin
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