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Free light chain and intact immunoglobulin abnormalities in heart transplant recipients: Two year follow-up timelines and clinical correlations
P. Sečník, P. Lavríková, L. Hošková, P. Malíková, A. Jabor, J. Franeková,
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, práce podpořená grantem
- MeSH
- dospělí MeSH
- imunoglobuliny - kappa-řetězce krev MeSH
- imunoglobuliny - lambda-řetězce krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- senioři MeSH
- transplantace srdce * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES: To assess the timelines of serum free light chain (sFLC) concentrations and the kappa/lambda light chain (K/L) ratio in heart transplant (HTX) recipients. To analyze the performance of serum protein electrophoresis (SPE), serum immunofixation (sIFE) and sFLC measurements for gammopathy detection following a HTX. METHODS: A total of 96 patients who underwent a HTX were analyzed during a two-year follow-up period. The relevant clinical data were obtained from patient medical records. SPE, sIFE and sFLC methods were used for the detection of free light chain and intact immunoglobulin gammopathies at 4 time points after HTX. RESULTS: A statistically significant decrease in sFLC K and L (a decrease of 39.1% and 27.6%, respectively, when compared to pretransplant values) was found 9months after the HTX (p<0.001, Friedman test). We detected SPE or sIFE abnormalities in 23 (8.4%) samples, and sFLC K/L ratio abnormalities in 34 (12.4%) samples. All of the K/L ratio abnormalities had normal SPE/sIFE values, and 19% of the findings were persistent. CONCLUSIONS: A significant and consistent dynamics in the sFLC concentration was found in the HTX patients during a 2-year follow-up period, which reflected changes in the immunosuppressant dosage. A remarkable number of monoclonal and polyclonal gammopathies was identified with some persistent abnormalities, using the SPE/sIFE and sFLC methods. Some of the detected abnormalities, which might possess a higher risk for PTLD if interpreted according to common practice in nonTX patients can only be detected by sFLC methods.
Citace poskytuje Crossref.org
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- $a Sečník, Peter $u Department of Clinical Biochemistry, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021 Prague, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic.
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- $a OBJECTIVES: To assess the timelines of serum free light chain (sFLC) concentrations and the kappa/lambda light chain (K/L) ratio in heart transplant (HTX) recipients. To analyze the performance of serum protein electrophoresis (SPE), serum immunofixation (sIFE) and sFLC measurements for gammopathy detection following a HTX. METHODS: A total of 96 patients who underwent a HTX were analyzed during a two-year follow-up period. The relevant clinical data were obtained from patient medical records. SPE, sIFE and sFLC methods were used for the detection of free light chain and intact immunoglobulin gammopathies at 4 time points after HTX. RESULTS: A statistically significant decrease in sFLC K and L (a decrease of 39.1% and 27.6%, respectively, when compared to pretransplant values) was found 9months after the HTX (p<0.001, Friedman test). We detected SPE or sIFE abnormalities in 23 (8.4%) samples, and sFLC K/L ratio abnormalities in 34 (12.4%) samples. All of the K/L ratio abnormalities had normal SPE/sIFE values, and 19% of the findings were persistent. CONCLUSIONS: A significant and consistent dynamics in the sFLC concentration was found in the HTX patients during a 2-year follow-up period, which reflected changes in the immunosuppressant dosage. A remarkable number of monoclonal and polyclonal gammopathies was identified with some persistent abnormalities, using the SPE/sIFE and sFLC methods. Some of the detected abnormalities, which might possess a higher risk for PTLD if interpreted according to common practice in nonTX patients can only be detected by sFLC methods.
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- $a Lavríková, Petra $u Department of Clinical Biochemistry, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021 Prague, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic.
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- $a Hošková, Lenka $u Cardiology Clinic, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021 Prague, Czech Republic.
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- $a Jabor, Antonín $u Department of Clinical Biochemistry, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021 Prague, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic.
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- $a Franeková, Janka $u Department of Clinical Biochemistry, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021 Prague, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 10000 Prague, Czech Republic. Electronic address: jafa@ikem.cz.
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