Utilisation of sFLC assays - how well do we comply with guidelines?
Date
2012
Authors
Phillips, David
Talaulikar, Dipti
Hawkins, Carolyn
Hickman, Peter
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley-Blackwell
Abstract
Introduction: There is a paucity of data on the utilisation of the serum-free light chain (sFLC) and compliance with published guidelines. Methods: Serum-free light chain assays requested at our institute for the diagnosis, prognosis and monitoring of plasma cell dyscrasias from July 2008 to March 2010 were compared with the International Myeloma Working Group (IMWG) consensus guidelines. Results: In total, 1150 assays were performed (4.3 assays per patient, range 1-20). Eight hundred and forty-four (73%) of these were performed for multiple myeloma (MM), 188 (16%) for monoclonal gammopathy of undetermined significance, 72 (6%) for AL amyloidosis and 46 (4%) for smouldering myeloma. Of these, 49.6%, 22.9%, 1.4% and 69.6% of the monitoring assays were outside of IMWG recommendations, respectively. Of the 419 assays performed outside of guidelines for MM patients, 404 (96.4%) were due to monitoring of patients with a measurable M protein, while 24 (5.7%) were due to too frequent requesting (≤14 days) with 15 assays (3.6%) being noncompliant on both grounds. Conclusion: Utilisation of the sFLC assay shows reasonable adherence to guidelines within our centre. We propose to further optimise usage of the test with the help of administrative processes and education of clinicians.
Description
Keywords
Keywords: calcium; creatinine; M protein; amyloidosis; article; blood cell count; bone marrow biopsy; calcium blood level; creatinine blood level; diagnostic procedure; human; major clinical study; monoclonal immunoglobulinemia; multiple myeloma; myeloma; plasma ce Free light chain assay; Monoclonal gammopathy of undetermined significance; Myeloma; Plasma cell dyscrasia; Serum-free light chain
Citation
Collections
Source
International Journal of Laboratory Hematology
Type
Journal article
Book Title
Entity type
Access Statement
License Rights
Restricted until
2037-12-31