Free light chains in the blood of subjects in rural areas of the Manabí province, Ecuador
Keywords:
free light chains; monoclonal component; monoclonal gammopathy; multiple myelomaAbstract
Introduction: Monoclonal gammopathies are characterized by the stable or progressive proliferation of a clone of plasma cells. The most prevalent is monoclonal gammopathy of uncertain significance, with a risk of developing multiple myeloma; exposure to agrochemicals may be a predisposing factor. Excessive secretion of free light chains in these diseases occurs before the symptoms of a monoclonal gammopathy appear and can cause kidney damage, among other complications.
Objective: To analyze the levels of free light chains in the blood of subjects from rural areas of Manabí.
Methods: Descriptive, observational, cross-sectional and prospective study. 88 samples that presented results of monoclonal peaks and/or distortions in the proteinogram profile were chosen and the free light chains test was performed.
Results: The age range with the highest frequency of pathological cases was between 56-62 years. The female sex, the Montubia ethnic group and people linked to agricultural work predominated. The free k/λ ratio was pathological in 77% of the subjects, with kappa predominating. There was no significant difference between the free κ/λ ratio in terms of sex, but there was a significant difference between mestizo and montubio subjects, and it was highly significant in farmers with respect to other occupations.
Conclusions: The levels of the free κ/λ ratio in the blood of subjects from rural areas of Manabí demonstrated to be statistically higher in self-declared mestizo people and in farmers who are exposed to toxic substances. The results found indicate the presence of a possible monoclonal gammopathy in this population.
Downloads
References
Kaseb H, Annamaraju P, Babiker HM. Monoclonal Gammopathy of Undetermined Significance [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [citado 25/09/2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK507880/
Cowan AJ, Green DJ, Kwok M, et al. Diagnosis and Management of Multiple Myeloma: A Review. JAMA [Internet]. 2022 [citado 25/09/2024];327(5):464-77. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35103762/
Altamirano P, Leone PE. Estudios genéticos del mieloma múltiple en el Ecuador [Internet]. Salamanca: Agencia Iberoamericana para la Difusión de la Ciencia y la Tecnología; 2016 [citado 03/10/2024]. Disponible en: https://www.dicyt.com/noticias/estudios-geneticos-del-mieloma-multiple-en-el-ecuador
Leone PE, Cabrera-Andrade A, García-Cárdenas JM, et al. Ancestry study in Ecuadorian population with multiple myeloma. Forensic Sci Int Genet [Internet]. 2017 [citado 03/10/2024];6:e435-6. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1875176817302743
Martellosio JP, Leleu X, Roblot P, et al. Dosage des chaînes légères libres: indications et méthodes. Rev Med Interne [Internet]. 2019 [citado 03/10/2024];40(5):297-305. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0248866319300451
Sarto C, Intra J, Fania C, et al. Monoclonal free light chain detection and quantification: Performances and limits of available laboratory assays. Clin Biochem [Internet]. 2021 [citado 03/10/2024];95:28-33. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33991536/
Lutteri L, Aldenhoff MC, Cavalier E. Evaluation of the new Sebia free light chain assay using the AP22 ELITE instrument. Clin Chim Acta [Internet]. 2018 [citado 03/10/2024];487:161-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30243748/
Willrich MAV, Murray DL, Rajkumar SV, et al. Comparison of two free light chain assays: performance of the involved free light chain ratio and implications for diagnosis of multiple myeloma. Blood Cancer J [Internet]. 2022 [citado 03/10/2024];12(9):127. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36055996/
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 [Internet]. 2009 [citado 03/10/2024];23(2):215-24. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19020545/
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol [Internet]. 2014 [citado 03/10/2024];15(12):e538-48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25439696/
Wadhera RK, Rajkumar SV. Prevalence of Monoclonal Gammopathy of Undetermined Significance: A Systematic Review. Mayo Clin Proc [Internet]. 2010 [citado 03/10/2024];85(10):933-42. Disponible en: https://pubmed.ncbi.nlm.nih.gov/20713974/
Barrachina NC. Prevalencia de gammapatías monoclonales en una población estadounidense de alto riesgo. MPG Journal [Internet]. 2023 [citado 03/10/2024];4(60). Disponible en: https://mpgjournal.mpg.es/index.php/journal/article/view/753
Alejo E, Puertas B, Mateos MV. Gammapatía monoclonal de significado incierto. Med Clín [Internet]. 2023 [citado 03/10/2024];161(5):217-24. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/ibc-224739
Han JH, Wang JN, Zhang YL, et al. Prevalence of monoclonal gammopathy of undetermined significance in a large population with annual medical check-ups in China. Blood Cancer J [Internet]. 2020 [citado 03/10/2024];10(3):34. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32152278/
Bertrand KA, Zirpoli G, Niharika Pillalamarri B, et al. Prevalence of monoclonal gammopathy of undetermined significance in US black women. Am J Hematol [Internet]. 2022 [citado 03/10/2024];97(9):E341-3. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35723873/
Huber JH, Ji M, Shih YH, et al. Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study. Nat Commun [Internet]. 2023 [citado 03/10/2024];14(1):5768. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37730703/
Leone PE, Belén M, Diana C, et al. Datos de Ecuador en la Red Iberoamericana para la Investigación de Mieloma Múltiple. Oncología [Internet]. 2013 [citado 03/10/2024];23(1):7-16. Disponible en: https://www.imbiomed.com.mx/articulo.php?id=110266
Moura LTR, Bedor CNG, Lopez RVM, et al. Occupational exposure to organophosphate pesticides and hematologic neoplasms: a systematic review. Rev Bras Epidemiol [Internet]. 2020 [citado 03/10/2024];23:e200022. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32401913/
Hofmann JN, Beane Freeman LE, Murata K, et al. Lifetime Pesticide Use and Monoclonal Gammopathy of Undetermined Significance in a Prospective Cohort of Male Farmers. Environ Health Perspect [Internet]. 2021 [citado 03/10/2024];129(1):17003. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33404262/
International Myeloma Foundation. Tests to assess monoclonal protein [Internet]. California: International Myeloma Foundation; 2024 [citado 25/09/2024]. Disponible en: https://www.myeloma.org/monoclonal-protein-tests
Binding Site Latinoamérica. Why is it necessary to measure kappa and lambda free light chains? [Internet]. Naucalpan: Binding Site Latinoamérica; 2022 [citado 25/09/2024]. Disponible en: https://www.bindingsitelatam.com/cadenas-ligeras-libres-kappa-lambda/
Bermudo C, Cárdenas MC, Cortés M, et al. Valor diagnóstico del cociente de cadenas ligeras libres de inmunoglobulinas en suero en las gammapatías monoclonales de significado incierto. Rev Lab Clín [Internet]. 2012 [citado 03/10/2024];5(3):111-5. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/ibc-105598
Medina S, Espiño M, Alenda R, et al. Marcadores pronósticos en pacientes con gammapatía monoclonal de significado incierto. Inmunología [Internet]. 1987 [citado 03/10/2024];33(1):6-10. Disponible en: https://pesquisa.bvsalud.org/portal/resource/en;/ibc-125458
Zambrano AK, Gaviria A, Cobos-Navarrete S, et al. The three-hybrid genetic composition of an Ecuadorian population using AIMs-InDels compared with autosomes, mitochondrial DNA and Y chromosome data. Sci Rep [Internet]. 2019 [citado 03/10/2024];9(1):9247. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31239502/
Rajkumar SV. Value and Cost of Myeloma Therapy. Am Soc Clin Oncol Educ Book [Internet]. 2018 [citado 03/10/2024];38:662-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30231405/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista Médica Electrónica (Medical Electronic Journal)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.
It allows:
- Copy and redistribute published material in any medium or format.
- Adapt the content.
This will be done under the following terms:
- Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.
- Non-commercial use.
- Recognize the journal where it is published.
The copyrights of each article are maintained, without restrictions.
Guidelines to authors
