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2010, Número 4

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Rev Hematol Mex 2010; 11 (4)


Identificación de cadenas ligeras libres en suero y su aplicación en las gammapatías monoclonales

Barbosa-de-Carvalho NM, Morais-Sarmento-Campos ML

Idioma: Español
Referencias bibliográficas: 56
Paginas: 199-207
Archivo PDF: 189.42 Kb.


RESUMEN

Las gammapatías monoclonales engloban un amplio espectro de diferentes entidades en las cuales el pilar del diagnostico y de su seguimiento es la identificación y caracterización de la proteína monoclonal, producida por un clon anormal de células plasmáticas. El aumento de los niveles de las cadenas ligeras de inmunoglobulina es un evento frecuente en estos pacientes. Recientemente, la introducción de un nuevo inmunoensayo sérico para la determinación de las cadenas ligeras libres kappa y lambda ha proporcionado una nueva herramienta para el cribado, diagnostico, pronóstico y seguimiento del mieloma múltiple y otras discrasias de células plasmáticas. En el presente documento revisamos la biología de la producción de las cadenas ligeras y su metabolismo, los diferentes ensayos para la determinación de las mismas, así como el inmunoensayo de las cadenas ligeras libres en suero y su aplicación. Al día de hoy, se recomienda su utilización en todas las gammapatías monoclonales en el momento del cribado, diagnóstico y pronóstico, siendo además su uso obligatorio en la monitorización de entidades como el mieloma múltiple no secretor/oligoescretor y la amiloidosis primaria y en todos los pacientes para definir el concepto de respuesta completa estricta.


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