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J Clin Pathol doi:10.1136/jclinpath-2012-200669
  • Short report

Association of plasma cell subsets in the bone marrow and free light chain concentrations in the serum of monoclonal gammopathy patients

  1. Nazira Sumar1
  1. 1Department of Immunology, Epsom and St Helier University Hospitals NHS Trust, Carshalton, Surrey, UK
  2. 2Department of Haematology, Epsom and St Helier University Hospitals NHS Trust, Carshalton, Surrey, UK
  1. Correspondence to Michael John Ayliffe, Department of Immunology, St Helier Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK; michael.ayliffe{at}talktalk.net

  1. Contributors MA conceived and designed the study, acquired, analysed and interpreted the data, and was involved in the drafting, revision and the decision to submit the paper for publication. NS performed the statistical analysis, interpreted data and was involved in the drafting, revision and the decision to submit the paper for publication. JB and SS provided clinical input and were involved in the drafting, revision and the decision to submit the paper for publication.

  • Accepted 10 January 2012
  • Published Online First 1 June 2012

Abstract

This study investigated bone marrow plasma cell subsets and monoclonal free light chain concentrations in blood of monoclonal gammopathy patients. 54 bone marrow samples were stained by double immunofluorescence to enumerate cellular subsets making either intact monoclonal immunoglobulin or free light chains only. Blood taken at the same time was assayed for free light chains by an automated immunoassay. Patients were assigned to three cellular population categories: single intact monoclonal immunoglobulin (59%), dual monoclonal immunoglobulin and free light chain only (31%), or single free light chain only (9%). The median affected free light chain concentration of each group was 75 mg/l, 903 mg/l and 3320 mg/l, respectively, but with substantial overlap. In myeloma patients the difference in serum free light chain concentrations between patients with free light chain only marrow cells and those without was statistically significant. Serum free light chain levels >600 mg/l result mostly from marrow cells restricted to free light chain production.

Footnotes

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval London–Surrey Borders Research Ethics Committee approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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