Immunofixation (IFE), Serum, Protein Electrophoresis (PE), Serum, and Quantitative Free κ and λ Light Chains (FLC) Plus Ratio, Serum
CPT:
82784(x3); 83521(x2); 84155; 84165; 86334
Synonyms
- Free Light Chains, Quantitative, Serum
- Freelite®
- Globulins, Serum
- IEP, Serum
- IFE, Serum and Protein Electrophoresis, Serum
- Immunoelectrophoresis for Myeloma Proteins
- Kappa Free Light Chains, Quantitative, Serum
- Kappa:Lambda Free Light Chains Ratio, Quantitative, Serum
- Lambda Free Light Chains, Quantitative, Serum
- Light Chains, Free κ and Free λ, Quantitative, Serum
- Protein IEP
- Serum IFE
Test Includes
Quantitation of serum immunoglobulins IgA, IgG, and IgM; IFE qualitative interpretation of heavy- and light-chain patterns; serum protein electrophoresis; quantitation of serum free κ and λ light chains plus κ:λ ratio
Special Instructions
State patient's age and clinical diagnosis on the test request form.
Expected Turnaround Time
3 - 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
For more information, please view the literature below.
Serum Free Light Chain Assays for Diagnosis and Monitoring of Myeloma
Specimen Requirements
Specimen
Serum
Volume
5.5 mL
Minimum Volume
2.2 mL
Container
Red-top tube or gel-barrier tube
Collection
Sample should be allowed to clot and the serum separated as soon as possible to prevent hemolysis.
Storage Instructions
IFE: Refrigerated. PE and FLC: Room temperature
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 14 days |
Refrigerated | 14 days |
Frozen | 14 days |
Freeze/thaw cycles | Stable x3 |
Patient Preparation
Overnight fasting is preferred, but not required.
Causes for Rejection
Plasma sample
Test Details
Use
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
Methodology
Electrophoresis followed by immunodiffusion against monospecific antisera to immunoglobulin and individual heavy and light chains (IFE); protein electrophoresis on agarose media; turbidimetric quantitation of IgA, IgG, and IgM; turbidimetric quantitation of free κ and λ light chains
Additional Information
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
Footnotes
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): 215-224.19020545
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 120256 | IFE, PE and FLC, Serum | 001776 | Immunoglobulin G, Qn, Serum | mg/dL | 2465-3 | |
| 120256 | IFE, PE and FLC, Serum | 001784 | Immunoglobulin A, Qn, Serum | mg/dL | 2458-8 | |
| 120256 | IFE, PE and FLC, Serum | 001792 | Immunoglobulin M, Qn, Serum | mg/dL | 2472-9 | |
| 120256 | IFE, PE and FLC, Serum | 001073 | Protein, Total | g/dL | 2885-2 | |
| 120256 | IFE, PE and FLC, Serum | 149520 | Albumin | g/dL | 2862-1 | |
| 120256 | IFE, PE and FLC, Serum | 149521 | Alpha-1-Globulin | g/dL | 2865-4 | |
| 120256 | IFE, PE and FLC, Serum | 149522 | Alpha-2-Globulin | g/dL | 2868-8 | |
| 120256 | IFE, PE and FLC, Serum | 149523 | Beta Globulin | g/dL | 2871-2 | |
| 120256 | IFE, PE and FLC, Serum | 149524 | Gamma Globulin | g/dL | 2874-6 | |
| 120256 | IFE, PE and FLC, Serum | 149525 | M-Spike | g/dL | 33358-3 | |
| 120256 | IFE, PE and FLC, Serum | 149530 | Globulin, Total | g/dL | 2336-6 | |
| 120256 | IFE, PE and FLC, Serum | 149531 | A/G Ratio | 1759-0 | ||
| 120256 | IFE, PE and FLC, Serum | 149519 | Immunofixation Result, Serum | 13169-8 | ||
| 120256 | IFE, PE and FLC, Serum | 149534 | Please note: | 77202-0 | ||
| 120256 | IFE, PE and FLC, Serum | 001498 | 11502-2 | |||
| 120256 | IFE, PE and FLC, Serum | 121138 | Free Kappa Lt Chains,S | mg/L | 36916-5 | |
| 120256 | IFE, PE and FLC, Serum | 121139 | Free Lambda Lt Chains,S | mg/L | 33944-0 | |
| 120256 | IFE, PE and FLC, Serum | 121141 | Kappa/Lambda Ratio,S | 48378-4 |
| Reflex Table for Immunofixation Result, Serum | ||||||
|---|---|---|---|---|---|---|
| Order Code | Order Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 149532 | Immunofixation Interp.,Sr | 149532 | Immunofixation Interp.,Sr | 13169-8 | |
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