Studies in multiple myeloma

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In 1848 Bence Jones1 first reported finding an abnormal protein in the urine of a patient with multiple myeloma. Since that time, tests for detection of this protein have been considered important in the clinical evaluation of patients with this disease. Recent studies have shown this protein to be identical with the light chains of immunoglobulin molecules. Immunoelectrophoresis has enabled investigators not only to detect light chains (L-chains) in serum and urine but to classify them into two major types: kappa and lambda. In a previous report, the general characteristics of multiple myeloma as observed in 98 patients were described.2 This report documents the occurrence and distribution of light chains (both free and in association with intact Ig molecules) and their prognostic significance in the same group of patients.

Materials and methods

The material for this report was collected from 126 cases of monoclonal gammopathy evaluated from 1965 to 1972. There were 94 patients with myeloma proteins which could be typed for light chains (Table 1). Only cases of IgG, IgA, and Bence Jones myelomas were numerous enough for evaluation; two cases of IgD myeloma have been reported.2

The clinical parameters evaluated, diagnostic criteria employed, and laboratory tests performed have been described.2 Serum or urine specimens or both were analyzed by Immunoelectrophoresis in ionagar using a barbital buffer at pH 8.6. Specific antilight chain antisera were obtained commercially* as well as prepared in the laboratory. In many cases, urine specimens were also analyzed with a Bence Jones heat test using . . .



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