Trimolecular complexes of λ light chain dimers in serum of a patient with multiple myeloma

Roshini S. Abraham, M. Cristine Charlesworth, Barbara A.L. Owen, Linda M. Benson, Jerry A. Katzmann, Craig B. Reeder, Robert A. Kyle

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background: Patients with multiple myeloma often have Bence Jones proteins composed of free monoclonal light chains of the κ or λ type in their urine. Usually, these light chains exist as monomeric or dimeric forms, but rarely, larger molecules, such as tetramers, have been reported in the serum. Methods and Results: We report the presence of trimeric complexes of λ light chain dimers in a patient who was diagnosed with a free λ light chain multiple myeloma 2 years earlier and subsequently underwent a stem cell transplant. Recently, the patient presented with a large serum M-spike (23 g/L) by protein electrophoresis. The spike consisted of monoclonal λ light chains without a heavy chain. The urine contained only 8 mg of λ light chain in a 24-h specimen. Quantitative analysis of the serum and urinary free light chains (FLCs) indicated the probability of larger aggregates of FLCs. Size-exclusion chromatography, electrophoresis, analytical ultracentrifugation, and mass spectrometric studies of the serum revealed almost exclusively the presence of trimolecular aggregates of λ light chain dimers without other multimeric species. Conclusion: Monoclonal λ light chains may present as hexameric aggregates that cannot be cleared by renal excretion.

Original languageEnglish (US)
Pages (from-to)1805-1811
Number of pages7
JournalClinical chemistry
Volume48
Issue number10
DOIs
StatePublished - Oct 1 2002

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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