Objective: To assess the value of immunoglobulin heavy/light chain (HLC) immunoassay on therapeutic response in patients with multiple myeloma(MM). Methods: A total of 45 newly diagnosed MM patients were retrospectively enrolled in Peking Union Medical College Hospital from 2013 to 2016, whose 115 serum samples were consecutively collected. HLC was tested to evaluate response and compare with other methods for M protein detection. Results: ①There were 30 males and 15 females in total of whom the monoclonal immunoglobulin was IgG in 27 (IgGκ∶IgGλ 12∶15) and IgA (IgAκ∶IgAλ 9∶9) in 18. The arerage age of the studied population was 59 (range 43-80) . ② In 34 patients with serum sample at diagnosis, 32 (94.1%) had abnormal HLC ratio (rHLC) while 2 patients with IgG had normal rHLC. The percentages of abnormal rHLC was 81.8% (18/22) at partial response、50.0%(9/18) at very good complete response and 16.0%(4/25) at complete response. ③In 25 patients reaching CR, there were 13 with IgG and 12 with IgA. 4 patients equally split of IgG and IgA had abnormal rHLC at complete response. ④By monitoring the rHLC of some patients consecutively, we found that the remission of rHLC was to some extent behind the remission of SPE and IEF, or even rFLC. Conclusion: Immunoglobulin HLC detection is one feasible method for minimal residual disease detection.
目的： 评价重轻链（HLC）检测在多发性骨髓瘤（MM）疗效评价中的意义。 方法： 纳入2013至2016年北京协和医院诊治的45例MM患者，连续收集其治疗过程中115份血清。采用常规M蛋白检查及HLC比值（rHLC）法同时评估疗效。 结果： ①45例患者中男30例，女15例，平均年龄59（43~80）岁，其中IgG型27例（IgGκ 12例，IgGλ 15例），IgA型18例（IgAκ和IgAλ各9例）。②治疗前34例患者留取了血清标本，rHLC异常检出率为94.1%（32/34），2例rHLC正常的患者均为IgG型，部分缓解（PR）、非常好的部分缓解(VGPR)、完全缓解（CR）时rHLC异常检出率分别为81.8%（18/22）、50.0%（9/18）、16.0%（4/25），结果显示随着治疗后缓解程度的加深，rHLC异常率逐渐下降。③25例CR患者中IgG型13例，IgA型12例，其中有4例患者rHLC异常（IgG型和IgA型各2例）。④对同一患者进行HLC动态监测，发现rHLC恢复正常较M蛋白转阴（血清蛋白电泳、免疫固定电泳）及游离轻链恢复正常延迟。 结论： rHLC检测可以作为MM患者微小残留病的辅助评价手段。.
Keywords: Immunoglobulin heavy chains; Immunoglobulin light chains; Multiple myeloma; Treatment outcome.