好色先生

好色先生

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

CSF kappa Free Light Chains as a Potential Quantitative Alternative to Oligoclonal Bands in Multiple Sclerosis
Multiple Sclerosis
S37 - MS Biomarkers (1:00 PM-1:11 PM)
001

Detection of OCB in cerebrospinal fluid (CSF) has been reintroduced in the revised 2017 McDonald’s criteria. Measurement of cKFLC has been demonstrated to be consistent with intrathecal immunoglobulin synthesis and has comparable performance to OCB for the diagnosis of MS.

Validating clinical application of cerebrospinal fluid kappa free light chain (cKFLC) assay as a quantitative alternative to oligoclonal bands (OCB) in multiple sclerosis (MS).

A total of 702 retrospective and 660 prospective paired CSF/serum samples from residual waste samples of physician-ordered OCB testing were obtained and tested for cKFLC. Charts were reviewed by a neurologist blinded to cKFLC results. Specificity and sensitivity for MS diagnosis were evaluated to establish a diagnostic cut-off value for cKFLC in the retrospective cohort, which was then validated in the prospective cohort.

The retrospective and prospective subgroups, respectively, included MS (n=88, 71), non-MS (n=604, 569) and undetermined diagnosis (excluded from analysis, n =8, 17). CSF detection of 2 unique OCB compared with a cKFLC value of 0.1 mg/dL. In the retrospective subgroup, cKFLC vs. OCB sensitivities for the diagnosis of MS were 67.0 vs. 73.6 (p=0.083) and specificities were 86.1 vs. 87.6 (p=0.27,) respectively. cKFLC AUC (95% CI) was 0.766 (0.714 - 0.817), while that for OCB was 0.806 (0.757 - 0.854). In the prospective cohort, cKFLC vs. OCB sensitivity 74.6 (p=1.0) for both and specificities were 87.3 vs 89.6 (p=0.08), respectively.

In comparison to current standards of detecting 2 unique CSF OCB, cKFLC at a value of 0.1 mg/dL showed comparable sensitivity and specificity to support diagnosis of MS. cKFLC is a valid alternative to OCB, offering a standardized quantitative measure, eliminating human error associated with OCB testing and reducing cost and turnover time of testing, with comparable sensitivity and specificity.

Authors/Disclosures
Ruba S. Saadeh, MBBS (Mayo Clinic)
PRESENTER
No disclosure on file
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology) Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. The institution of Dr. Pittock has received research support from Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from F. Hoffman/LaRoche/Genentech. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
No disclosure on file
David Murray No disclosure on file
No disclosure on file
No disclosure on file
Andrew McKeon, MD (Mayo Clinic) The institution of Dr. McKeon has received research support from National Institutes of Health. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received publishing royalties from a publication relating to health care.
No disclosure on file