Ward 160

Morphology aside for the moment, it is worth noting that more than 60% of patients with light-chain disease are panhypoglobulinemic at diagnosis. Monoclonal spikes (M-spikes) are typically not seen in serum ELPs. The protein products of light-chain myeloma cells consist entirely of either kappa or lambda chains (also known as Bence-Jones protein). These low molecular weight protein chains easily traverse glomerular basement membranes and in the absence of renal failure usually do not pile up in the serum. Instead, they accumulate in substantial amounts in urine, usually creating an M-spike between beta and the fast gamma regions.. (The Clinical Spectrum of Light Chain Myeloma. Stone MJ and Frenkel EP. Am. J. Med. 1975. 58, 601-619). Morphologically, the cells of light-chain myeloma tend to be more “primitive” than those of other myelomas (Light-chain disease. An abortive variant of multiple myeloma. Williams RC, Brunning RD, and Wollheim FA. Ann.Intern Med 65:471,1966).