Analyze Heavy/Light Chain Isotype with Hevylite® assays
What is this test?
What are Hevylite assays?
The six Hevylite assays are fully automated for the quantification of individual heavy + light chain isotypes in serum: IgGκ, IgGλ, IgAκ, IgAλ, IgMκ, and IgMλ.
Hevylite assays can identify plasma cell clonality by calculating the heavy + light chain (HLC) ratio.
Hevylite assays uniquely measure both the involved and uninvolved immunoglobulin.
Measuring the uninvolved heavy and light chain (HLC), can provide additional information not available with standard paraprotein assessments such as serum protein electrophoresis (SPE), capillary zone electrophoresis (CZE), serum immunofixation electrophoresis (sIFE), and total immunoglobulins.
Optimizing management of Multiple Myeloma
- Quantitative estimation without subjective interpretation
- Quantifies both involved and uninvolved immunoglobulin
- Can aid in the identification of plasma cell clonality through calculation of the heavy + light chain (HLC) ratio
- Sensitive tests for monitoring previously diagnosed IgG κ&λ and IgA κ&λ Multiple Myeloma patients
- Acknowledged by the International Myeloma Working Group (IMWG) as an assay useful in patients with oligo-secretory disease, and can overcome limitations associated with monitoring β-migrating monoclonal IgA by electrophoresis
- Achieve greater clarity when measuring IgG κ&λ or IgA κ&λ monoclonal proteins and overcome the laboratory challenges of electrophoresis
- HLC-matched pair suppression can provide an indication of immunoglobulin response
- Highly sensitive Hevylite assays can measure beyond complete response
- Identifies extremely low levels of disease
- Early detection of relapse, remission, or progression in Multiple Myeloma
- Recognises clonal change
Only IgG and IgA κ&λ Hevylite assays are indicated for monitoring Multiple Myeloma patients
- Hevylite assays are useful for monitoring monoclonal gammopathies such as Multiple Myeloma and oligo-secretory Multiple Myeloma
- These assays can detect monoclonality even when total immunoglobulin levels are within the normal range
- Hevylite assays may identify plasma cell clonality
- An abnormal κ/λ (IgG, IgA or IgM) ratio with suppression of the uninvolved immunoglobulin may provide valuable information about a patient's immunoglobulin response
Overcome challenges seen with conventional methods
| Hevylite | SPE | IFE | |
| Quantification of monocolonal protein* | ✔️ | ✔️ | ✘ |
| Avoids subjective interpretation | ✔️ | ✘ | ✘ |
| Accurate measurements below 10 g/L | ✔️ | ✘ | ✘ |
| Quantification of uninvolved HLC (unique immunosuppression data) | ✔️ | ✘ | ✘ |
| Comparison Information |
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* Through quantification of heavy and light chain isotypes
Better Management, Better Care
A proposed algorithm for optimal management of Multiple Myeloma using Freelite® and Hevylite assays
- M-protein quantification on SPE and urine protein electrophoresis (UPE) can be challenging to quantify <10g/L
- In addition to the recommended IMWG workflow, alongside the use of Freelite assays to monitor Multiple Myeloma patients of all isotypes, previously diagnosed IgG κ&λ and IgA κ&λ can be additionally monitored with Hevylite assays. This may capture early relapse, clonal change, and progression of Multiple Myeloma
If M-protein is measurable (≥10 g/L on SPE and/or ≥200 mg/24h UPE)
Monitor with SPE/UPE and with Freelite assays to detect Light Chain escape
+
Monitor with Freelite & Hevylite assays at every assessment
If M-protein is not measurable (<10 g/L on SPE and/or <200 mg/24h UPE)
Monitor with Freelite assays if FLC ≥ 100mg/L with an abnormal sFLC ratio
+
Monitor with Freelite & Hevylite assays at every assessment
Adapted from IMWG guidelines for diagnosis and monitoring of multiple myeloma11,12
Represent proposed additions
Only IgG and IgA Hevylite assays are indicated for monitoring.
References
- Dejoie T, et al. Leukemia 2019; 33:313-318
- Michallet M, et al. Leukemia 2018; 32:376-382