Evaluation of the Effectiveness of the Heavy-Light Chain Quantitative Test

ABSTRACT

BACKGROUND: The heavy-light chain (HLC) quantitative test can identify and quantify the heavy and light chains of each immunoglobulin class. The purpose of this study was to evaluate the effectiveness of the HLC quantitative test. METHODS: To evaluate the effectiveness of the HLC quantitative test, a systemic review of the literature, using Ovid-MEDLINE, EMBASE, Cochrane library, and eight domestic databases including KoreaMed, was performed until October 10, 2013. We included five cohort studies and one diagnostic evaluation study in the final evaluation. Two reviewers independently assessed the quality of the included studies and extracted data from the studies. The quality of the studies was assessed according to the Scottish Intercollegiate Guidelines Network (SIGN) tool. RESULTS: A correlation between the HLC quantitative test and previous assays was evaluated in one study, which enrolled patients with increased monoclonal IgA. The correlation coefficient was reported as 0.94 in this study. The clinical significance of the quantitative HLC test to predict a prognosis was also reported in five cohort studies. The survival rate in patients with higher HLC ratio was significantly lower and the increased IgA kappa/lambda ratio or IgM kappa/lambda ratio was significantly correlated with higher survival rate in patients with monoclonal gammaglobulinemia. CONCLUSIONS: The HLC quantitative test is an effective test that can quantitatively measure the identified immunoglobulin type and predict the prognosis of patients with monoclonal gammopathy.