Ordering Recommendations

Aids in the diagnosis and monitoring of monoclonal gammopathies. Panel includes serum free light chain testing, eliminating the need for urine monoclonal studies as part of initial screening. Use to detect, quantify, and characterize serum monoclonal protein.

Collect

Serum separator tube (SST).

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 2.5 mL serum to an ARUP standard transport tube. (Min: 2.0 mL)

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month

Unacceptable Conditions

Plasma. Room temperature specimens.

Notes

A copy of the graph will follow the final report. This assay is highly sensitive to increasing concentrations of monoclonal free kappa or free lambda light chains in the serum of patients with evolving or relapsing myelomas.

Referral Lab

Laboratories.

Performed

Sun-Sat

Reported

1-5 days

Methodology

Qualitative Immunofixation Electrophoresis (IFE)/Quantitative Capillary Electrophoresis/Quantitative Immunoturbidimetry/Colorimetry

Reference Interval

Components
Reference Interval
Albumin3.75-5.01 g/dL
Alpha 1 Globulin0.19-0.46 g/dL
Alpha 2 Globulin0.48-1.05 g/dL
Beta Globulin0.48-1.10 g/dL
Gamma0.62-1.51 g/dL
Immunoglobulin A
AgeReference Interval (mg/dL)
0-2 years2-126
3-4 years14-212
5-9 years52-226
10-14 years42-345
15-18 years60-349
19 years and older68-408

Immunoglobulin G
AgeReference Interval (mg/dL)
0-2 years242-1108
3-4 years485-1160
5-9 years514-1672
10-14 years581-1652
15-18 years479-1433
19 years and older768-1632

Immunoglobulin M
AgeReference Interval (mg/dL)
0-2 years21-215
3-4 years26-155
5-9 years26-188
10-14 years47-252
15-18 years26-232
19 years and older35-263

Total Protein, SerumRefer to report. Reference intervals may vary based on instrumentation.
Kappa Qnt Free Light Chains3.30 - 19.40 mg/L
Lambda Qnt Free Light Chains5.71-26.30 mg/L
Kappa/Lambda Free Light Chain Ratio0.26-1.65
Monoclonal Protein<=0.00 g/dL

Interpretive Data

Undetected antigen excess is a rare event but cannot be excluded. Free light chain results should always be interpreted in conjunction with other clinical and laboratory findings.

Synonyms

  • SPEP
  • Mutiple Myeloma Study
  • Monoclonal Protein Study
  • MGUS study
  • Lambda Qnt Free Light Chains
  • Kappa/Lambda Free Light Chains
  • Kappa/Lambda Free Light Chain Ratio
  • Kappa Qnt Free Light Chains
  • Immunofixation, serum
  • IgA, IgG, and IgM
  • IFE

CPT Codes

82784 x3; 84155; 84165; 86334; 83521 x2

LOINC

  • 2862-1
  • 2865-4
  • 2868-8
  • 2871-2
  • 2874-6
  • 25700-6
  • 2458-8
  • 2465-3
  • 2472-9
  • 2885-2
  • 36916-5
  • 33944-0
  • 80517-6
  • 49275-1
  • 33358-3
  • 11502-2
Collecting

Ordering Recommendations

Aids in the diagnosis and monitoring of monoclonal gammopathies. Panel includes serum free light chain testing, eliminating the need for urine monoclonal studies as part of initial screening. Use to detect, quantify, and characterize serum monoclonal protein.

Collect

Serum separator tube (SST).

Specimen Preparation

Separate from cells ASAP or within 2 hours of collection. Transfer 2.5 mL serum to an ARUP standard transport tube. (Min: 2.0 mL)

Storage/Transport Temperature

Refrigerated.

Stability (from collection to initiation)

After separation from cells: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month

Unacceptable Conditions

Plasma. Room temperature specimens.

Notes

A copy of the graph will follow the final report. This assay is highly sensitive to increasing concentrations of monoclonal free kappa or free lambda light chains in the serum of patients with evolving or relapsing myelomas.

Referral Lab

Laboratories.
Resulting

Performed

Sun-Sat

Reported

1-5 days

Methodology

Qualitative Immunofixation Electrophoresis (IFE)/Quantitative Capillary Electrophoresis/Quantitative Immunoturbidimetry/Colorimetry

Reference Interval

Components
Reference Interval
Albumin3.75-5.01 g/dL
Alpha 1 Globulin0.19-0.46 g/dL
Alpha 2 Globulin0.48-1.05 g/dL
Beta Globulin0.48-1.10 g/dL
Gamma0.62-1.51 g/dL
Immunoglobulin A
AgeReference Interval (mg/dL)
0-2 years2-126
3-4 years14-212
5-9 years52-226
10-14 years42-345
15-18 years60-349
19 years and older68-408

Immunoglobulin G
AgeReference Interval (mg/dL)
0-2 years242-1108
3-4 years485-1160
5-9 years514-1672
10-14 years581-1652
15-18 years479-1433
19 years and older768-1632

Immunoglobulin M
AgeReference Interval (mg/dL)
0-2 years21-215
3-4 years26-155
5-9 years26-188
10-14 years47-252
15-18 years26-232
19 years and older35-263

Total Protein, SerumRefer to report. Reference intervals may vary based on instrumentation.
Kappa Qnt Free Light Chains3.30 - 19.40 mg/L
Lambda Qnt Free Light Chains5.71-26.30 mg/L
Kappa/Lambda Free Light Chain Ratio0.26-1.65
Monoclonal Protein<=0.00 g/dL

Interpretive Data

Undetected antigen excess is a rare event but cannot be excluded. Free light chain results should always be interpreted in conjunction with other clinical and laboratory findings.

Additional Information

Synonyms

  • SPEP
  • Mutiple Myeloma Study
  • Monoclonal Protein Study
  • MGUS study
  • Lambda Qnt Free Light Chains
  • Kappa/Lambda Free Light Chains
  • Kappa/Lambda Free Light Chain Ratio
  • Kappa Qnt Free Light Chains
  • Immunofixation, serum
  • IgA, IgG, and IgM
  • IFE
Coding

CPT Codes

82784 x3; 84155; 84165; 86334; 83521 x2
Interface Mapping

LOINC

  • 2862-1
  • 2865-4
  • 2868-8
  • 2871-2
  • 2874-6
  • 25700-6
  • 2458-8
  • 2465-3
  • 2472-9
  • 2885-2
  • 36916-5
  • 33944-0
  • 80517-6
  • 49275-1
  • 33358-3
  • 11502-2

ARUP Consult®

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