How many more MM patients will be detected if sFLC assays are run alongside SPE?
LCMM comprises between 15-18% of all MM. Approximately, half to two thirds of these patients will have abnormalities by SPE. This especially applies to patients who are producing large quantities of FLCs, are in renal failure or have associated hypogammaglobulinaemia. The remaining LCMM patients with normal SPE (5-7%) and 70% of those with NSMM (2%) will be detected by sFLC assays. Most patients with AL amyloidosis and other rare monoclonal gammopathies will also be detected. In addition, normal individuals with FLC MGUS will be identified. Intact immunoglobulin MGUS occurs in approximately 3% of people aged over 70 and more frequently with increasing age. Therefore, at least 10-15% additional patients with monoclonal gammopathies will be detected using sFLC. The study by Bakshi et al., detected an additional 50% of patients and included B-CLL and other plasma cell dyscrasias.
