Light-chain Disease

Abstract

Twenty-one percent of 110 myeloma patients studied showed relative hypogammaglobulinemia by ordinary electrophoresis. Nine of 10 living patients showed marked elevations of free serum L-chain predominantly of 1 major L-chain type. Myeloma patients with sharp serum M-components also showed free serum L-chains and in 11%, the same concentrations as the hypogammaglobulinemic patients. Attempts to detect the presence of small quantities of whole 7S myeloma protein by Gm character, immunologic deficiency, or H-chain sub-grouping of gamma-globulin fractions of hypogammaglobulinemic sera were unsuccessful. Two of 10 patients studied provided evidence for trace amounts of M-components within a low background gamma-globulin of normal character. Hypogammaglobulinemia multiple myeloma, clinically similar to the usual disease spectrum of multiple myeloma, may reflect an abortive attempt at whole myeloma protein synthesis, or selective suppression of concomitant monoclonal H-chain synthesis.