Immunofixation (IFE), Serum; Protein Electrophoresis (PE); Free Kappa and Gamma Light Chains + Ratio

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Category:

Turnaround Time: 2 - 5 days
CPT Code:

82784(3); 83883(x2); 84155; 84165; 86334

Test Type: 5.5 mL Serum
Stability Time:

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3
Reference Range:


Immunoglobulin G, Qn, Serum mg/dL 586-1602
Immunoglobulin A, Qn, Serum mg/dL 87-352
Immunoglobulin M, Qn, Serum mg/dL 26-217
Protein, Total g/dL 6.0-8.5
Albumin g/dL 2.9-4.4
Alpha-1-Globulin g/dL 0.0-0.4
Alpha-2-Globulin g/dL 0.4-1.0
Beta Globulin g/dL 0.7-1.3
Gamma Globulin g/dL 0.4-1.8
M-Spik3 g/dL Not Observed
Globulin, Total g/dL 2.2-3.9
A/G Ratio 0.7-1.7
Free Kappa Lt Chains,S mg/L 3.3-19.4
Free Lambda Lt Chains,S mg/L 5.7-26.3
Kappa/Lambda Ratio,S 0.26-1.65

Overview:

Detect and identify monoclonal gammopathy (M protein) found on serum protein electrophoresis; diagnose myeloma, macroglobulinemia of Waldenström; evaluate amyloidosis; evaluate lymphoproliferative disease (malignant lymphoma and others) and collagen disease in general; diagnose and characterize immune deficient and dysgammaglobulinemic states

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) recommend the use of serum free light chain assays in the initial diagnostic work-up of multiple myeloma and related disorders.

"Use of free light chain (FLC) assay along with SPEP and SIFE yields high sensitivity while screening for MM and related plasma cell disorders. Therefore, this assay is now included as a part of the initial diagnostic work-up in the NCCN Multiple Myeloma Guidelines."1

If screening for plasma cell dyscrasias, the International Myeloma Working Group recommends a screening panel consisting of serum free light chain assay, serum protein electrophoresis (SPEP), and serum immunofixation (IFE) to maximize sensitivity. (A 24-hour urine IFE can be added if AL amyloidosis is suspected.)2


1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) for Multiple Myeloma, Version 1.2011. Fort Washington, Pa: NCCN; 2011.

2. Dispenzieri A, Kyle R, Merlini G, et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia. 2009 Feb; 23(2): 215-224. PubMed 19020545

Collection Details:

Patient Preparation:

Patient should be fasting.

Collection Instructions:

State patient's age and clinical diagnosis on the test request form.

Red-top tube or gel-barrier tube.

Sample should be allowed to clot and the serum separated as soon as possible to prevent hemolysis.

IFE: Refrigerated. PE and FLC: Room temperature.